Anderson Simon G, Ratib Karim, Myint Phyo K, Keavney Bernard, Kwok Chun Shing, Zaman Azfar, Ludman Peter F, de Belder Mark A, Nolan James, Mamas Mamas A
Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom.
Cardiovascular Research Group, Institute of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Catheter Cardiovasc Interv. 2015 Nov 15;86(6):965-72. doi: 10.1002/ccd.25896. Epub 2015 Feb 25.
We investigate adoption of the TRA in different age groups and study the relationship between age and access site related outcomes in a national cohort of patients undergoing PCI in the UK. Previous studies have reported conflicting data on radial access site adoption between different age groups, with age an independent predictor of failure of procedures undertaken through the radial approach. Age and access site related outcomes (based on transradial (TRA) and transfemoral (TFA) access) were studied in 469,983 PCI procedures undertaken in the UK from 2006 to 2012 in the age groups; <60, 60-<70, 70-<80, and ≥80 in the British Cardiovascular Intervention Society database. We studied access site practice in 469,983 patients who underwent PCI procedures in the United Kingdom. TRA utilization increased from 17.5% to 65.6% in the age group <60, and 16.6% to 54.5% in the age group ≥80 between 2006 and 2012. TRA was independently associated with decreased 30-day mortality in all age groups (<60: OR 0.64; 95% CI 0.54-0.74, P < 0.0001; 60-<70: OR 0.65; 95% CI 0.57-75, P < 0.0001, 70-<80: OR 0.58 (0.52-0.65, P < 0.0001 and ≥80: OR 0.65 (0.57-0.73, P < 0.0001). Adoption of the TRA for PCI has occurred least in older patients in the UK despite similar associations between TRA use and decreased 30-day mortality observed in all age groups.
我们在不同年龄组中研究经桡动脉途径(TRA)的采用情况,并在英国接受经皮冠状动脉介入治疗(PCI)的全国队列患者中研究年龄与穿刺部位相关结局之间的关系。既往研究报告了不同年龄组之间经桡动脉穿刺部位采用情况的数据相互矛盾,年龄是经桡动脉途径手术失败的独立预测因素。在英国心血管介入学会数据库中,对2006年至2012年期间年龄组<60岁、60 - <70岁、70 - <80岁和≥80岁的469983例PCI手术的年龄和穿刺部位相关结局(基于经桡动脉(TRA)和经股动脉(TFA)穿刺)进行了研究。我们研究了在英国接受PCI手术的469983例患者的穿刺部位实践情况。2006年至2012年期间,<60岁年龄组的TRA使用率从17.5%增至65.6%,≥80岁年龄组从16.6%增至54.5%。在所有年龄组中,TRA与30天死亡率降低独立相关(<60岁:比值比(OR)0.64;95%置信区间(CI)0.54 - 0.74,P < 0.0001;60 - <70岁:OR 0.65;95% CI 0.57 - 0.75,P < 0.0001,70 - <80岁:OR 0.58(0.52 - 0.65,P < 0.0001),≥80岁:OR 0.65(0.57 - 0.73,P < 0.0001)。尽管在所有年龄组中均观察到TRA使用与30天死亡率降低之间存在相似关联,但在英国老年患者中,PCI采用TRA的情况最少。