Transradial Intervention in Dialysis Patients Undergoing Percutaneous Coronary Intervention: a Japanese Nationwide Registry Study

Overview

Journal Eur Heart J Open

Specialty Cardiology & Vascular Diseases

Date 2023 Dec 18

PMID 38105921

Authors

Toshiki Kuno

Kyohei Yamaji

Tadao Aikawa

Mitsuaki Sawano

Tomo Ando

Yohei Numasawa

Hideki Wada

Tetsuya Amano

Ken Kozuma

Shun Kohsaka

Affiliations

Soon will be listed here.

Abstract

Aims: Transradial intervention (TRI) for percutaneous coronary intervention (PCI) is used to reduce periprocedural complications. However, its effectiveness and safety for patients on dialysis are not well established. We aimed to investigate the association of TRI with in-hospital complications in dialysis patients undergoing PCI.

Methods And Results: We included 44 462 patients on dialysis who underwent PCI using Japanese nationwide PCI registry data (2019-21) regardless of acute or chronic coronary syndrome. Patients were categorized based on access site: TRI, transfemoral intervention (TFI). Periprocedural access site bleeding complication requiring transfusion was the primary outcome and in-hospital death, and other periprocedural complications were the secondary outcomes. Matched weighted analysis was performed for TRI and TFI. Here, 8267 (18.6%) underwent TRI, and 36 195 (81.4%) underwent TFI. Patients who received TRI were older and had lower rates of comorbidities than those who received TFI. Access site bleeding rate and in-hospital death were significantly lower in the TRI group (0.1% vs. 0.7%, < 0.001; 1.8% vs. 3.2%, < 0.001, respectively). After adjustment, TRI was associated with a lower risk of access site bleeding (odds ratio [OR] [95% confidence interval (CI)]: 0.19 [0.099-0.38]; < 0.001) and in-hospital death (OR [95% CI]: 0.79 [0.65-0.96]; = 0.02). Other periprocedural complications between TRI and TFI were not significantly different.

Conclusion: In patients undergoing dialysis and PCI, TRI had a lower risk of access site bleeding and in-hospital death than TFI. This suggests that TRI may be safer for this patient population.

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