Access-site bleeding and radial artery occlusion in transradial primary percutaneous coronary intervention: influence of adjunctive antiplatelet therapy
Language English Country Great Britain, England Media print
Document type Comparative Study, Journal Article
- MeSH
- Abciximab MeSH
- Adenosine adverse effects analogs & derivatives MeSH
- Purinergic P2Y Receptor Antagonists adverse effects MeSH
- Radial Artery * diagnostic imaging MeSH
- Time Factors MeSH
- Hematoma chemically induced MeSH
- Hemostatic Techniques MeSH
- Immunoglobulin Fab Fragments adverse effects MeSH
- ST Elevation Myocardial Infarction diagnostic imaging therapy MeSH
- Platelet Aggregation Inhibitors adverse effects MeSH
- Clopidogrel MeSH
- Percutaneous Coronary Intervention adverse effects methods MeSH
- Hemorrhage chemically induced prevention & control MeSH
- Middle Aged MeSH
- Humans MeSH
- Antibodies, Monoclonal adverse effects MeSH
- Catheterization, Peripheral adverse effects methods MeSH
- Prasugrel Hydrochloride adverse effects MeSH
- Punctures MeSH
- Risk Factors MeSH
- Aged MeSH
- Ticagrelor MeSH
- Ticlopidine adverse effects analogs & derivatives MeSH
- Platelet Glycoprotein GPIIb-IIIa Complex drug effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Names of Substances
- Abciximab MeSH
- Adenosine MeSH
- Purinergic P2Y Receptor Antagonists MeSH
- Immunoglobulin Fab Fragments MeSH
- Platelet Aggregation Inhibitors MeSH
- Clopidogrel MeSH
- Antibodies, Monoclonal MeSH
- Prasugrel Hydrochloride MeSH
- Ticagrelor MeSH
- Ticlopidine MeSH
- Platelet Glycoprotein GPIIb-IIIa Complex MeSH
BACKGROUND: The aim of this study was to evaluate access-site complications in patients with ST-segment elevation myocardial infarction treated with a transradial primary percutaneous coronary intervention relative to three different P2Y12 platelet inhibitors. PATIENTS AND METHODS: We enrolled 334 consecutive patients (76.9% men, age: 59.4±9.1 years) treated by one of the following: clopidogrel (n=118), prasugrel (n=102), and ticagrelor (n=114). The use of the IIb/IIIa inhibitor, abciximab, was left to the operators' discretion. The time needed to achieve patent hemostasis, compression time, and local complications were analyzed. RESULTS: The baseline characteristics were similar in all three P2Y12 platelet inhibitor groups. Abciximab was used in 72 (21.6%) patients. Administration of abciximab was associated with a higher incidence of grade II and III hematomas (23.6 vs. 5.0%, P<0.0001, and 5.6 vs. 1.1%, P=0.041, respectively). Among different platelet P2Y12 receptor inhibitor groups, the incidences of hematomas grade II and III were similar in patients who did (P≥0.14) and did not (P≥0.31) receive abciximab. There were no grade IV or V hematomas in any of the groups. Patent hemostasis was achieved faster (24.5±13.4 vs. 43.5±30.0 min, P<0.0001) and compression time was shorter (113.2±53.6 vs. 217.8±115.5 min, P<0.0001) when abciximab was not used. Radial artery occlusion occurred in one (0.3%) patient. CONCLUSION: After transradial primary percutaneous coronary intervention, early patent hemostasis and short artery compression times were associated with a higher incidence of local hematomas. The incidence of hematomas was dependent on the use of abciximab, but unrelated to the type of P2Y12 inhibitor used. All hematomas were without clinical consequences.
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