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The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk.

Authors
Park, KH; Jeong, MH; Ahn, Y; Jung, SS; Kim, MH; Yang, HM; Yoon, J; Rha, SW; Park, KS; Han, KR; Cho, BR; Cha, KS; Kim, BO; Hyon, MS; Shin, WY; Choe, H; Bae, JW; Kim, HY; Trans-Radial Intervention Registry Investigators
Citation
Journal of Korean medical science, 28(9):1307-1315, 2013
Journal Title
Journal of Korean medical science
ISSN
1011-89341598-6357
Abstract
The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0% vs 9.4%, P = 0.048; 4.5% vs 9.4%, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1% vs 15.0%, P < 0.001; 7.2% vs 30.0%, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95% confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.
MeSH terms
Acute Coronary Syndrome/mortality/*pathologyAgedFemaleFemoral Artery*HemorrhageHospital MortalityHumansKaplan-Meier EstimateMaleMiddle AgedOdds RatioPercutaneous Coronary InterventionRadial ArteryRetrospective StudiesRisk FactorsStentsTreatment Outcome
DOI
10.3346/jkms.2013.28.9.1307
PMID
24015035
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
양, 형모
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