Complete transitioning to the radial approach for primary percutaneous coronary intervention: a real-world single-center registry of 1808 consecutive patients with acute ST-elevation myocardial infarction

J Invasive Cardiol. 2014 Sep;26(9):475-82.


Objectives: To compare the short- and long-term outcomes of transradial approach (TRA) versus transfemoral approach (TFA) for primary percutaneous coronary intervention (PPCI) during a complete institutional transition from TFA to TRA.

Methods and results: An all-comer population of ST-elevation myocardial infarction (STEMI) patients (n=1808) who underwent PPCI using TRA (n=1162) and TFA (n=646) from October 2007 to December 2010 were enrolled. TRA was used in 25% of PPCIs by 2007 and in 96% of PPCIs in 2010. Primary endpoints were cardiovascular death and major adverse cardiac event (MACE), defined as a composite of death, stroke, reinfarction, and target vessel revascularization at 30 days and 1 year. At 30 days, TRA compared to TFA was associated with a significant reduction of cardiovascular mortality (5.2% vs 10.5%; P<.001), significant MACE reduction (7.3% vs 12.5%; P<.001), fewer access-site complications (0.9% vs 8.2%; P<.001), and lower TIMI major bleeding (1.1% vs 4.3%; P<.001). At 1 year, the cardiovascular mortality and MACE rates were also in favor of the TRA group (6.9% vs 11.5%; P<.001 and 11.6% vs 20.1%; P<.001), respectively.

Conclusion: Complete transition from femoral access to a preferred radial access is safe and effective for STEMI patients undergoing PPCI, with a favorable effect on short- and long-term outcomes.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use
  • Cohort Studies
  • Death, Sudden, Cardiac / epidemiology
  • Electrocardiography*
  • Female
  • Femoral Artery*
  • Hemostasis, Surgical
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology*
  • Myocardial Infarction / therapy*
  • Percutaneous Coronary Intervention / methods*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Radial Artery*
  • Registries
  • Retrospective Studies
  • Stroke / epidemiology
  • Treatment Outcome


  • Anticoagulants
  • Platelet Aggregation Inhibitors