Impact of Arterial Access Route on Bleeding Complications in Japanese Patients Undergoing Percutaneous Coronary Intervention　– Insight From the PRASFIT Trial –

• Saito Shigeru

  Division of Cardiology, Shonan Kamakura General Hospital

• Isshiki Takaaki

  Ageo Central General Hospital

• Kimura Takeshi

  Graduate School of Medicine, Kyoto University

• Ogawa Hisao

  Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University National Cerebral and Cardiovascular Center

• Yokoi Hiroyoshi

  Fukuoka Sanno Hospital International University of Health and Welfare

• Nishikawa Masakatsu

  Clinical Research Support Center, Mie University Hospital

• Miyazaki Shunichi

  Division of Cardiology, Department of Medicine, Faculty of Medicine, Kinki University

• Tanaka Yuko

  Clinical Data and Biostatistics Department, R&D Division, Daiichi Sankyo, Co Ltd

• Nakamura Masato

  Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University

• on behalf of the PRASFIT-ACS and PRASFIT-Elective Investigators

抄録

Background:Few large-scale studies have examined the relationship between bleeding events not related to coronary artery bypass grafting (CABG), and the vascular access route used in acute coronary syndrome (ACS) or in elective treatment of coronary artery disease (CAD).Methods and Results:We compared the incidence of bleeding events occurring up to 3 days after percutaneous coronary intervention (PCI) or loading dose of prasugrel or clopidogrel in 2 studies of Japanese patients (PRASFIT-ACS, femoral and radial routes, n=683 and 531; PRASFIT-Elective, femoral and radial routes, n=135 and 508). Rates of periprocedural bleeding, bleeding not related to CABG, and puncture site bleeding were consistently lower in the radial access route group than in the femoral access route group in both studies. Risk factors for periprocedural bleeding included sex, body weight, age, and access route in PRASFIT-ACS (femoral access: hazard ratio [HR], 3.739; 95% confidence interval [CI]: 1.727–8.094; radial access: HR, 0.288; 95% CI: 0.128–0.65), and body weight, age, and access route in PRASFIT-Elective (femoral access: HR, 12.32; 95% CI 1.282–>100; radial access: HR, 0.125; 95% CI: 0.013–1.205).Conclusions:The incidence of periprocedural bleeding is lower with a radial access route than with a femoral access route for PCI in Japanese patients with ACS or those undergoing elective PCI for CAD. (Circ J 2015; 79: 1928–1937)

収録刊行物

• Circulation Journal

  Circulation Journal 79 (9), 1928-1937, 2015

  一般社団法人 日本循環器学会

キーワード

• Arterial access route
• Bleeding
• Femoral artery
• Percutaneous coronary intervention
• Radial artery

詳細情報

• CRID: 1390282680084521984
• NII論文ID: 130005095313
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-15-0276
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 026690311
• PubMed: 26040334
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I026690311
• Web Site: https://www.jstage.jst.go.jp/article/circj/79/9/79_CJ-15-0276/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2016111215
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可