Comparative study on transradial versus transfemoral approach for primary percutaneous coronary intervention in Chinese patients with acute myocardial infarction

OBJECTIVE: To compare the transradial approach and transfemoral approach for primary percutaneous coronary intervention (PCI) in Chinese patients with acute myocardium infarction (AMI).

METHODS: From August 2005 to September 2008, we randomly divided 200 AMI patients into transradial intervention (TRI) group and transfemoral intervention (TFI) group. The study took place in the Department of Cardiology, The Tenth People's Hospital, Tongji University, Shanghai, China. During the procedure, the puncture success, procedure success, infarction related artery (IRA), coronary flow, percentage of 3 vessel disease, stent used, and tirofiban used were observed. The procedural time intervals were also recorded. After the procedure, the major adverse cardiac events (MACEs) and the vascular complications were studied. In this trial, the hospital stay was also recorded.

RESULTS: The baseline clinical characteristics of the patients were similar in both groups. There were no statistical differences in IRA, 3 vessel disease, initial and finial thrombolysis in myocardial infarction (TIMI) flow, rate of stent and tirofiban used, and procedure rate (p>0.05). No statistical differences were observed in the puncture time, cannulation time, reperfusion time, procedural time, and fluoroscopy time in both groups (p>0.05). There was no statistical difference in the incidence of MACEs between the 2 groups (p>0.05). Not only the vascular complications were lower in the TRI group (p<0.01), but also the total hospital stay was longer in the TFI group than in the TRI group (p<0.001).

CONCLUSION: Transradial intervention for Chinese patients with AMI yields comparable procedural success, and has fewer vascular access site complications compared with the TFI group.