Current Application Status of Artery Access in Percutaneous Coronary Intervention and Their Impact on Long-term Prognosis in Relevant Patients: A single Center Experience in 10577 Patients / 中国循环杂志

ABSTRACT

Objective: To explore the application status of trans-femoral route (TFR) and trans-radial route (TRR) percutaneous coronary intervention (PCI) via a single center large sample 2-year follow-up study and to evaluate their impact on long-term prognosis in relevant patients. Methods: A total of 10577 patients received PCI by TFR or TRR in our hospital during 2013 were analyzed. The patients were divided into two groups TRR group, n=9745 (90.9％) and the TFR group, n=812 (7.6％). Clinical features were compared between 2 groups and their impacts on prognosis were studied. Results: Compared with TRR group, TFR group had more patients with elder age, more female, diabetes, more with the histories of myocardial infarction (MI), PCI or CABG, all P<0.001; more patients with left main disease or 3-vessel lesions, all P<0.001. Logistic regression analysis indicated that female, age, histories of MI, PCI or CABG and left main disease were the predictors for choosing TFR. With propensity score matching, TFR group had the higher in-hospital mortality than TRR group, P<0.05. 2-year follow-up Kaplan-Meier survival analysis showed that the end point events were similar between 2 groups. Cox multivariate analysis found that TFR was an independent risk factor of BARC ≥ 2 bleeding (HR=2.210, P=0.013), while not an independent risk factor for main cardiac end point events. Conclusion: ① Female, elder age, histories of MI, PCI or CABG and left main disease were the predictors for choosing TFR. ② The in-hospital mortality was higher in TFR PCI. ③ TFR was an independent risk factor of BARC≥2 bleeding, while it had no impact on long-term prognosis in PCI patients.