Impact of transradial coronary intervention on bleeding complications in octogenarians

Cardiovasc Interv Ther. 2017 Jan;32(1):18-23. doi: 10.1007/s12928-016-0383-3. Epub 2016 Feb 24.

Abstract

Percutaneous coronary intervention (PCI) in the elderly is a major hospital burden since this group of patients exhibits high mortality rates and many comorbidities. The aim of this study was to analyze the impact of a transradial intervention (TRI) approach for PCI on bleeding complications in octogenarians. We retrospectively analyzed a consecutive cohort of 2530 patients who underwent PCI at a tertiary care center in Japan. Octogenarians constituted 12 % (291 cases) of the total PCI cases during the study period. Bleeding complications and all-cause mortality were observed at 30 days after PCI. Average age was 83 ± 3 years and female gender was 32 %. Stable coronary artery disease was 59 %. TRI was performed in 218 patients (75 %) and transfemoral intervention (TFI) in 73 (25 %). Bleeding Academic Research Consortium (BARC) major bleeding unrelated to bypass surgery were observed in 7.6 %, which were significantly lower in TRI than TFI (5.1 vs. 15.1 %, P = 0.005). The 30-day mortality rate was significantly low in patients without bleeding (4.9 vs. 31 %, p < 0.0001). In octogenarians, major bleeding complication was significant at 30 days after PCI. TRI had lower bleeding complication rate than TFI in this population. Octogenarians may be a subgroup of patients who derive benefits from TRI.

Keywords: Bleeding complications; Elderly; Percutaneous coronary intervention; Transradial intervention.

MeSH terms

  • Aged, 80 and over
  • Coronary Artery Disease / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Percutaneous Coronary Intervention / adverse effects*
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology*
  • Radial Artery
  • Retrospective Studies
  • Survival Rate / trends
  • Time Factors