Background:
In acute coronary syndrome, the use of multiple anticoagulation and antiplatelet drugs contributes to the risk of bleeding, including vascular access site bleeding, particularly in female patients. The use of the radial artery as a vascular access has shown to reduce the incidence of complications.
Methods:
Retrospective study including patients with acute coronary syndrome undergoing percutaneous coronary intervention by radial access, divided by gender. Patient profiles were analyzed, as well as the early and late outcomes.
Results:
Patients with acute coronary syndrome (n = 188) were submitted to percutaneous coronary intervention using the radial access and 34.6% of them were female. Clinical variables were similar between groups, except for the EuroSCORE and creatinine clearance, characterizing a slightly more complex profile in women. There were no differences in angiographic and procedure-related characteristics for most of the variables. Two thirds of the patients had multivessel disease and type non-C lesions were the most treated lesions. In-hospital death rates (5.8% vs. 5.5%; p = 0.81), myocardial infarction (1.4% vs. 0; p = 0.76) and emergency percutaneous intervention (1.4% vs 0; p = 0.76) were similar between groups and severe bleeding was rare (1.4% vs 0; p = 0.76). In the late follow-up, major adverse cardiac events (18.3% vs. 17.1%; p = 0.67) were similar.
Conclusions:
The transradial approach for per-cutaneous coronary intervention proved to be as effective in women as in men in the setting of acute coronary syndrome, with a high success rate and similar clinical outcomes. It also proved to be safe, since bleeding events were rare in the evaluated population.
Acute coronary syndrome; Percutaneous coronary intervention; Radial artery; Hemorrhage; Sex factors