Efficacy of transradial approach in the treatment of acute myocardial infarction with direct coronary intervention and its influence on inflammatory factors / 中国医师进修杂志

ABSTRACT

Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.