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

for the J-PCI Investigators

Research output: Contribution to journalArticle

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 < 0.001) and by 0.34% with IV (p = 0.127). A significantly lower risk for access site bleeding was observed by 0.34% with PS (p < 0.001) and by 0.53% with IV (p < 0.001). Radial access was related to a significantly lower risk for access site bleeding compared with femoral access, even without strong antithrombotic drugs for ACS in Japan, and may also relate to lower risk for a wider set of post-treatment adverse events.

Original languageEnglish
Pages (from-to)297-304
Number of pages8
JournalCardiovascular Intervention and Therapeutics
Volume34
Issue number4
DOIs
Publication statusPublished - 01-10-2019

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Acute Coronary Syndrome
Blood Vessels
Registries
Japan
Propensity Score
Databases
Hemorrhage
Thigh
Therapeutics
Incidence
Percutaneous Coronary Intervention
Stents
Length of Stay
Thrombosis
Myocardial Infarction
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "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",
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 < 0.001) and by 0.34{\%} with IV (p = 0.127). A significantly lower risk for access site bleeding was observed by 0.34{\%} with PS (p < 0.001) and by 0.53{\%} with IV (p < 0.001). Radial access was related to a significantly lower risk for access site bleeding compared with femoral access, even without strong antithrombotic drugs for ACS in Japan, and may also relate to lower risk for a wider set of post-treatment adverse events.",
author = "{for the J-PCI Investigators} and Toshiharu Fujii and Yuji Ikari and Hideki Hashimoto and Kazushige Kadota and Tetsuya Amano and Shiro Uemura and Hiroaki Takashima and Masato Nakamura and Nobuo Shiode and Nobuhiro Tanaka and Takashi Akasaka and Yoshihiro Morino and Kenshi Fujii and Hiroshi Hikichi and Kenshi Fujii and Shun Kohsaka and Hideki Ishii and Kengo Tanabe and Yukio Ozaki and Satoru Sumitsuji and Osamu Iida and Hidehiko Hara and Shinichi Shirai and Mamoru Nanasato and Taku Inohara and Yasunori Ueda and Yohei Numasawa and Shigetaka Noma",
year = "2019",
month = "10",
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doi = "10.1007/s12928-019-00582-0",
language = "English",
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pages = "297--304",
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TY - JOUR

T1 - Post-interventional adverse event risk by vascular access site among patients with acute coronary syndrome in Japan

T2 - observational analysis with a national registry J-PCI database

AU - for the J-PCI Investigators

AU - Fujii, Toshiharu

AU - Ikari, Yuji

AU - Hashimoto, Hideki

AU - Kadota, Kazushige

AU - Amano, Tetsuya

AU - Uemura, Shiro

AU - Takashima, Hiroaki

AU - Nakamura, Masato

AU - Shiode, Nobuo

AU - Tanaka, Nobuhiro

AU - Akasaka, Takashi

AU - Morino, Yoshihiro

AU - Fujii, Kenshi

AU - Hikichi, Hiroshi

AU - Fujii, Kenshi

AU - Kohsaka, Shun

AU - Ishii, Hideki

AU - Tanabe, Kengo

AU - Ozaki, Yukio

AU - Sumitsuji, Satoru

AU - Iida, Osamu

AU - Hara, Hidehiko

AU - Shirai, Shinichi

AU - Nanasato, Mamoru

AU - Inohara, Taku

AU - Ueda, Yasunori

AU - Numasawa, Yohei

AU - Noma, Shigetaka

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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 < 0.001) and by 0.34% with IV (p = 0.127). A significantly lower risk for access site bleeding was observed by 0.34% with PS (p < 0.001) and by 0.53% with IV (p < 0.001). Radial access was related to a significantly lower risk for access site bleeding compared with femoral access, even without strong antithrombotic drugs for ACS in Japan, and may also relate to lower risk for a wider set of post-treatment adverse events.

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