Post-interventional adverse event risk by vascular access site among patients with acute coronary syndrome in Japan: obs
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ORIGINAL ARTICLE
Post‑interventional adverse event risk by vascular access site among patients with acute coronary syndrome in Japan: observational analysis with a national registry J‑PCI database Toshiharu Fujii1 · Yuji Ikari1 · Hideki Hashimoto2 · Kazushige Kadota3 · Tetsuya Amano4 · Shiro Uemura5 · Hiroaki Takashima4 · Masato Nakamura6 · for the J-PCI Investigators Received: 16 January 2019 / Accepted: 4 March 2019 © Japanese Association of Cardiovascular Intervention and Therapeutics 2019
Abstract This study evaluated whether radial access intervention had a lower risk of post-treatment adverse events in acute coronary syndrome (ACS) even in Japan where the use of a strong antithrombotic regimen was not approved. We retrospectively analyzed a large nation-wide registry in Japan to compare the incidence of post-treatment adverse events according to the types of vessel access (trans-radial; TRI vs. trans-femoral; TFI) among ACS cases (n = 76,835; 43,288 TRI group and 33,547 TFI group). Primary outcome was a composite of in-hospital death, myocardial infarction associated with percutaneous coronary intervention, bleeding complication requiring transfusion, and stent thrombosis during in-hospital stay. Propensity score matching (PS) and instrumental variable (IV) analyses were used to account for treatment selection. The incidence of post-treatment adverse events was lower in the TRI group by 0.95% compared to the TFI group with PS (p
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