Benefits of radial approach in STEMI. Data from ORPKI registry, T Tokarek/Z Siudak

1. Benefits in bleeding rates and periprocedural
mortality of radial approach in ST-Segment Elevation
Myocardial Infarction. Propensity score analysis of
data from ORPKI Polish National Registry
1
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University
Medical College, Kraków, Poland
2
Department of Cardiology, Pinczow
3
2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University, Medical
College, Krakow, Poland
Authors: Tomasz Tokarek1
, Tomasz Wysocki2
, Zbigniew Siudak1
, Agata Sawina3
, Jacek
Legutko3
, Krzysztof Żmudka1
, Dariusz Dudek1
.

2. Potential conflicts of interest
(in regard to this presentation)
Speaker’s name: Tomasz Tokarek
I have the following potential conflicts of interest to report:
I do not have any potential conflict of interest.

3. Background
• The utilization of the radial access (RA) for
percutaneous coronary intervention (PCI) has
gradually increased.
• Recent studies suggest an advantage over
femoral access (FA) in high-risk patients with
ST-segment elevation myocardial infarction
(STEMI).
• Although technically more demanding, RA has
been recently demonstrated as feasible in the
STEMI setting.

4. • To evaluate bleeding complications and
periprocedural outcomes with safety and
efficacy of RA compared with FA for PCI
with stent implantation in „real-world”
patients with STEMI presentation from
Polish National Registry (ORPKI)

5. Data of 22,812 consecutive patients with STEMI treated with
PCI and stent implantation between January 2014 and June
2015 in 151 tertiary invasive cardiology centres in Poland.
Propensity score match
FA - 9,335 pts (40.9%) RA - 13,480 pts (59.1%)
6,542 matched pairs

6. Results
Baseline patients characteristics before propensity match score

7. Angiographic indications for percutaneous coronary
intervention
0.98%
7.77% 1.28%
89.77%
Radial access (n=6,542) Femoral access (n=6,542)
0.64%
7.49% 1.16%
90.39%
P=0.2
Single-vessel
disease
Multi-vessel disease
without LMCA
Multi-vessel
disease with LMCA
LMCA

8. % of patients with target leasion in particular vessels
Radial
Femoral
P=0.3

9. P=0.7
Radial Femoral

10. Radial Femoral
P=0.002

11. Percutaneous coronary intervention details
Results

12. Results
In –hospital antiplatelet & antithrombotic therapy

13. Results
Periprocedural and in-hospital results of PCI

14. Conclusions
• RA was associated with lower incidence of
periprocedural death in STEMI patients
• Significant reduction of bleeding complications
at access site both during hospitalization and
after PCI was observed in RA group
• Periprocedural cardiac arrest was significantly
less frequently reported after PCI with RA, more
allergic reactions occurred in RA group

15. Thank you for attentionThank you for attention
Foto. Andrzej Barabasz