Transradial vs Transfemoral Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: A...

Area of Science:

• Cardiology
• Interventional Cardiology
• Clinical Trials

Background:

• ST-segment elevation myocardial infarction (STEMI) requires timely reperfusion therapy.
• Percutaneous coronary intervention (PCI) is a primary treatment for STEMI.
• Vascular access site choice (transradial vs. transfemoral) impacts PCI outcomes.

Purpose of the Study:

• To conduct a meta-analysis evaluating the safety and efficacy of the transradial versus transfemoral approach for primary PCI in STEMI patients.
• To compare key clinical outcomes between the two vascular access methods.

Main Methods:

• Systematic search of randomized controlled trials comparing transradial and transfemoral approaches in STEMI patients undergoing PCI.
• Inclusion of studies from major databases: PubMed, Embase, CENTRAL, CINAHL, and clinicaltrials.gov.
• Application of random effect models to pool effect sizes for various outcome measures.

Main Results:

• Sixteen trials with 9726 patients showed transradial PCI significantly reduced all-cause mortality, major bleeding, access site bleeding, MACE, and hospital stay.
• Transradial approach demonstrated a 32.8% reduction in mortality and 48.1% in major bleeding.
• Stroke incidence was numerically higher with transradial but not statistically significant; heterogeneity was low.

Conclusions:

• The transradial approach is superior to the transfemoral approach for primary PCI in STEMI patients.
• Transradial PCI significantly lowers mortality, bleeding complications, and hospital length of stay.
• The transradial approach offers a safer and more effective strategy for STEMI management.