Abstract:
BACKGROUND:Despite lower risks of access site-related complications with transradial approach (TRA), its clinical benefit for percutaneous coronary intervention (PCI) is uncertain. We conducted a systematic review and meta-analysis of clinical studies comparing TRA and transfemoral approach (TFA) for PCI. METHODS:Randomized trials and observational studies (1993-2011) comparing TRA with TFA for PCI with reports of ischemic and bleeding outcomes were included. Crude and adjusted (for age and sex) odds ratios (OR) were estimated by a hierarchical Bayesian random-effects model with prespecified stratification for observational and randomized designs. The primary outcomes were rates of death, combined incidence of death or myocardial infarction, bleeding, and transfusions, early (≤ 30 days) and late after PCI. RESULTS:We collected data from 76 studies (15 randomized, 61 observational) involving a total of 761,919 patients. Compared with TFA, TRA was associated with a 78% reduction in bleeding (OR 0.22, 95% credible interval [CrI] 0.16-0.29) and 80% in transfusions (OR 0.20, 95% CrI 0.11-0.32). These findings were consistent in both randomized and observational studies. Early after PCI, there was a 44% reduction of mortality with TRA (OR 0.56, 95% CrI 0.45-0.67), although the effect was mainly due to observational studies (OR 0.52, 95% CrI 0.40-0.63, adjusted OR 0.49 [95% CrI 0.37-0.60]), with an OR of 0.80 (95% CrI 0.49-1.23) in randomized trials. CONCLUSION:Our results combining observational and randomized studies show that PCI performed by TRA is associated with substantially less risks of bleeding and transfusions compared with TFA. Benefit on the incidence of death or combined death or myocardial infarction is found in observational studies but remains inconclusive in randomized trials.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Bertrand OF,Bélisle P,Joyal D,Costerousse O,Rao SV,Jolly SS,Meerkin D,Joseph Ldoi
10.1016/j.ahj.2012.01.015subject
Has Abstractpub_date
2012-04-01 00:00:00pages
632-48issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(12)00062-2journal_volume
163pub_type
杂志文章,meta分析,评审abstract::Thallium-201 redistribution pattern after exercise was related to rest and exercise left ventricular regional and global function, measured by radionuclide ventriculography, in 61 patients, 50 with coronary artery disease (CAD). Sixteen patients had exclusively transient thallium defects, suggesting ischemia: in this ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90608-6
更新日期:1981-06-01 00:00:00
abstract::The effect of participation in cardiac rehabilitation on medical costs was determined by measuring hospitalization charges for cardiac admissions over a 3-year period in 580 post-coronary event patients (58% after coronary bypass surgery, 42% after myocardial infarction), of whom 230 entered a cardiac rehabilitation p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90696-s
更新日期:1992-04-01 00:00:00
abstract::We discuss the anatomy, physiology, and pathophysiology of epicardial adipose tissue and its relationship to coronary atherosclerosis. Epicardial fat stores triglyceride to supply free fatty acids for myocardial energy production and produces adipokines. It shares a common embryological origin with mesenteric and omen...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2007.03.019
更新日期:2007-06-01 00:00:00
abstract::The development of ECG Minnesota Q-QS codes and their subsequent evolution were studied in the first 692 subjects to enter the POSCH program who had had one MI. The mean interval from MI to entry into the study was 2.2 years. Sixty-three percent of the subjects developed the most significant code with the infarction. ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90169-3
更新日期:1985-08-01 00:00:00
abstract::The rate and form of creatine kinase-MB (CK-MB) enzyme release following reflow to ischemic myocardium has not been specifically examined in man. In this investigation, we examined the combined CK-MB time-activity curves during acute transmural myocardial infarction (AMI) in a group of patients receiving conventional ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90084-4
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Chronic periodontal infection is associated with an increased risk of coronary heart disease. Although the mechanism responsible for the relationship between periodontal disease and cardiovascular events is not fully understood, it is hypothesized that the chronic inflammatory burden of periodontal disease m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.10.002
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Elevations of creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) have an uncertain long-term prognostic value after coronary artery bypass graft (CABG) surgery. We aimed to test the hypothesis that CK-MB and cTnT are predictors of long-term survival after CABG and to assess which of these 2 biomarkers ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.05.027
更新日期:2012-11-01 00:00:00
abstract::The normal pattern of the myocardial sympathetic innervation was studied in 15 subjects using single photon emission computed tomography (SPECT) gamma scintigraphy with iodine 123-labeled meta-iodobenzylguanidine (I123MIBG). Seven young subjects (mean age 29.4 +/- 7.5 years SD) with supraventricular tachycardia and ei...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)91056-k
更新日期:1993-08-01 00:00:00
abstract::The resonant frequencies of five commonly used fluid-filled catheters connected to a solidstate microdisplacement pressure gauge were 18 to 33 per cent higher than those obtained with a conventional manometer. Four catheters had a flat amplitude response to 26 Hz. or more at the 20 per cent amplitude distortion level...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90508-6
更新日期:1975-05-01 00:00:00
abstract::In order to correlate the antiarrhythmic and electrophysiological effects of disopyramide phosphate during acute myocardial ischemia, we performed experiments in 17 mongrel dogs. Refractory periods obtained by the extrastimulus method and conduction times recorded from local electrograms were determined in potentially...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90046-2
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) regulate transcription of genes involved in glucose uptake, lipid metabolism, and inflammation. Aleglitazar is a potent dual PPAR agonist with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid profiles and biomarkers of cardiov...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2013.05.013
更新日期:2013-09-01 00:00:00
abstract::The effects of alcohol intake on serum lipids and lipoproteins depend on the dose and mode of alcohol intake, individual susceptibility, genetic variables, and dietary factors. Therefore the changes of lipoprotein pattern are different among moderate and heavy drinkers. Moderate intake of alcohol increases the concent...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(87)90614-4
更新日期:1987-02-01 00:00:00
abstract::We studied the possibility that a mitral regurgitant Doppler signal area on a two-dimensional color Doppler echocardiogram can reflect changes in mitral regurgitant volume in 24 patients with several types of mitral regurgitation. In 20 patients, mitral regurgitant Doppler signal areas were clear enough to measure. In...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90502-3
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Whether low-molecular-weight heparin (LMWH) is superior to unfractionated heparin (UFH) in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) remains unclear. METHODS:A total of 3,372 STEMI patients wh...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2009.12.041
更新日期:2010-04-01 00:00:00
abstract::Potential antiarrhythmic effects of calcium (slow-channel)-blocking drugs ca be indirect or direct. The indirect effect would affect ischemia-induced arrhythmias by improving myocardial perfusion or decreasing myocardial oxygen consumption. The direct effect would affect the electrical activity of the sinoatrial (SA) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90476-8
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:The randomized BASKET-PROVE study showed no significant differences between sirolimus-eluting stents (SES), everolimus-eluting stents (EES), and bare-metal stents (BMS) with respect to the primary end point, rates of death from cardiac causes, or myocardial infarction (MI) at 2 years of follow-up, in patient...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.11.007
更新日期:2016-03-01 00:00:00
abstract::We retrospectively contrasted the medical outcome of patients removed from the heart transplant consideration list because of clinical improvement with that of transplant recipients. Of 60 patients awaiting transplantation, 18 were removed from the list (group A), and 42 required transplant or died (group B). Group A ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90462-7
更新日期:1996-12-01 00:00:00
abstract::In older patients (70 ± 7 years) with chronic well-compensated heart failure with preserved ejection and controlled blood pressure, 6 months treatment with aliskiren (direct renin inhibitor) showed non-significant trends for modest improvements in peak exercise oxygen consumption (14.9 ± 0.2 mL kg-1 min-1 versus 14.4 ...
journal_title:American heart journal
pub_type: 信件
doi:10.1016/j.ahj.2018.03.019
更新日期:2018-07-01 00:00:00
abstract::There are many similarities between the clinical features of viral heart disease and of rheumatic carditis, as defined in the revised Jones criteria for the diagnosis of rheumatic fever. Because of this, it is likely that viral heart disease has been, and still is, diagnosed as rheumatic. This situation can be avoided...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80137-8
更新日期:1976-05-01 00:00:00
abstract::Three cases of large multiple coronary aneurysms, situated on both right and left coronary arteries, were seen in three middle-aged adult patients. These patients were hospitalized for myocardial infarction in two cases and for angina pectoris in the third case. On the coronary angiogram, the coronary lesions were qui...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90617-1
更新日期:1980-06-01 00:00:00
abstract::dal-PLAQUE is a placebo-controlled multicenter study designed to assess the effect of dalcetrapib on imaging measures of plaque inflammation and plaque burden. dal-PLAQUE is a multimodality imaging study in the context of the large dal-HEART Program. Decreased high-density lipoprotein cholesterol is linked to increase...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2011.05.006
更新日期:2011-08-01 00:00:00
abstract::In the United States there has been a dramatic decrease in age-adjusted coronary heart disease (CHD) mortality during the last 20 years. This article investigates the reasons for this decline and concludes that most of the decline in CHD has been the result of life-style changes, particularly reduction in serum choles...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(05)80054-7
更新日期:1990-03-01 00:00:00
abstract::Major depression is a common comorbidity associated with ischemic heart disease (IHD). There is growing evidence that psychological stress in general and depression in particular predispose to cardiovascular disease. Persons who have mental stress during daily life are at twice the risk of myocardial ischemia, and pat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2000.109979
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG). This study evaluated whether new-onset POAF is independently associated with long-term (>1 year) atrial fibrillation (AF) and mortality. METHODS:Among ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.12.010
更新日期:2014-04-01 00:00:00
abstract::Fifteen patients who arrived between 6 and 24 hours after the onset of acute myocardial infarction and who were found to have totally occluded coronary arteries, received aspirin, heparin, and tissue plasminogen activator given over 3 hours. Eight patients were randomly assigned to receive intravenous prostaglandin E1...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(94)90539-8
更新日期:1994-04-01 00:00:00
abstract::Atherosclerotic coronary artery disease is a serious clinical problem. Clinicians dealing with patients can make a diagnosis of coronary disease in several ways. Unfortunately all too often the diagnosis is made via sudden death or acute myocardial infarction. At other times the diagnosis is made by evaluation of pati...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(92)91039-4
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to test the hypothesis that patients with atherosclerotic cardiovascular (CV) disease optimally treated on a statin but with residual atherogenic dyslipidemia (low high-density lipoprotein cholesterol [HDL-C] and high triglycerides) will benefit from addition of niacin with fewer CV...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2010.11.017
更新日期:2011-03-01 00:00:00
abstract::Contrast bidimensional echocardiographic (2DE) studies were performed in eight patients with d-transposition of the great vessels in the postoperative period of the Senning technique. Contrast was injected into a peripheral vein of all patients, and into the arterial atrium in five in the postoperative period. The 2DE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90552-0
更新日期:1984-07-01 00:00:00
abstract::Of 178 transseptal left heart catheterizations performed, 173 successful cases are reported, with the use of a Swan-Ganz, flow-directed, balloon-tipped catheter. By means of a modified Brockenbrough technique, which is described in detail, a 10F Teflon tube (3.3 mm outside diameter) was inserted into the left atrium. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90603-9
更新日期:1985-02-01 00:00:00
abstract::To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combina...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90255-4
更新日期:1988-07-01 00:00:00