British Study Supports Transradial Access in Women for PCI

July 24, 2015—In the American Heart Journal (AHJ), Chun Shing Kwok, MBBS, et al published findings from a study that sought to define gender differences in access-site choice in practice and to evaluate associations between access-site choice and clinical outcomes for percutaneous coronary intervention (PCI) over a 6-year period through the analysis of the British Cardiovascular Intervention Society (BCIS) observational database (2015;170:164–172).

The investigators concluded that where possible, transradial (TR) access should be considered as the preferred access site choice for PCI, particularly in women in whom the greatest reductions in bleeding endpoints were observed across all indications.

As noted in the background to the study, gender is a strong predictor of periprocedural major bleeding complications after PCI. The access site represents an important site of such bleeding complications, which has driven adoption of the TR-access use during PCI, although female gender is an independent predictor of TR PCI failure.

As summarized in AHJ, the investigators reported that in-hospital major adverse cardiovascular events (a composite of in-hospital mortality and in-hospital myocardial reinfarction and target vessel revascularization), in-hospital bleeding complications, and 30-day mortality were studied based on gender and access site choice (transfemoral access or TR access) in 412,122 patients who underwent PCI between 2007 and 2012 in the United Kingdom. Use of TR access increased in both genders over time, although this lagged behind in women (21% in 2007 to 58% in 2012) compared with men (24% in 2007 to 64% in 2012). In both men and women, TR access was independently associated with a lower in-hospital major adverse cardiovascular event, in-hospital major bleeding, and 30-day mortality, respectively, reported the investigators in AHJ.