Lee Seung Hun, Jeong Myung Ho, Han Kyoo Rok, Sim Doo Sun, Yoon Junghan, Youn Young Jin, Cho Byung Ryeol, Cha Kwang Soo, Hyon Min Su, Rha Seung Woon, Kim Byung Ok, Shin Won Yong, Park Keum Soo, Cheong Sang Sig
The Heart Center of Chonnam, National University Hospital, Gwangju, Korea.
The Heart Center of Chonnam, National University Hospital, Gwangju, Korea.
Am J Cardiol. 2016 May 15;117(10):1582-1587. doi: 10.1016/j.amjcard.2016.02.030. Epub 2016 Mar 2.
Anemia is an independent predictor of bleeding complications and poor clinical outcomes after percutaneous coronary intervention. Percutaneous coronary transradial intervention (TRI) is better than percutaneous coronary transfemoral intervention (TFI) in terms of reducing bleeding complications that can affect the prognosis. This study aims to investigate the clinical outcomes between TRI and TFI for patients with anemia. We analyzed periprocedure complications, in-hospital mortality, and major adverse cardiac events for one year in the Korean TRI registry from January 2013 to April 2014. Patients with chronic kidney disease for whom TFI is preferred were excluded. Anemia was defined as hemoglobin <13 g/dl for men and <12 g/dl for women. A total of 1,279 patients were finally enrolled. Of these, 348 patients had anemia. Among them, 253 patients (72.7%) underwent TRI and 95 patients (27.3%) underwent TFI. There were no significant differences of baseline demographic characteristics between the TRI and TFI groups, except for the incidence of dyslipidemia (TRI 23.7% vs TFI 12.6%, p = 0.023). Multivariate logistic regression analysis revealed lower incidence of composite severe bleeding complications (hazard ratio 0.34, 95% CI 0.12 to 0.99, p = 0.049) and lower incidence of in-hospital mortality than TFI group (hazard ratio 0.74, 95% CI 0.62 to 0.88, p = 0.042). In conclusion, this study suggests that the TRI for patients with anemia may be translated into better prognosis in terms of lower rates of bleeding complications and in-hospital mortality.
贫血是经皮冠状动脉介入治疗后出血并发症及不良临床结局的独立预测因素。在减少可能影响预后的出血并发症方面，经皮冠状动脉桡动脉介入治疗（TRI）优于经皮冠状动脉股动脉介入治疗（TFI）。本研究旨在调查贫血患者接受TRI和TFI后的临床结局。我们分析了2013年1月至2014年4月韩国TRI登记处患者围手术期并发症、住院死亡率及一年内心脏主要不良事件。排除了首选TFI的慢性肾脏病患者。贫血定义为男性血红蛋白<13 g/dl，女性血红蛋白<12 g/dl。最终共纳入1279例患者。其中，348例患者患有贫血。其中，253例患者（72.7%）接受了TRI，95例患者（27.3%）接受了TFI。除血脂异常发生率外（TRI为23.7%，TFI为12.6%，p = 0.023），TRI组和TFI组基线人口统计学特征无显著差异。多因素logistic回归分析显示，与TFI组相比，复合严重出血并发症发生率较低（风险比0.34，95%可信区间0.12至0.99，p = 0.049），住院死亡率也较低（风险比0.74，95%可信区间0.62至0.88，p = 0.042）。总之，本研究表明，贫血患者接受TRI可能会因出血并发症发生率和住院死亡率较低而转化为更好的预后。
