Curative effects and safety of perradial or transfemoral percutaneous coronary interventions on ST- segment elevation myocardial infarction：a Meta-analysis
BU Guo-sen
LIU Zhi-qiang
HE Peng-yi
MU Hu-ya-ti
YANG Yu-chun
ZHANG Lei
Abstract：Objective To review systematically the curative effects and safety of perradial or transfemoral percutaneous coronary interventions (PCI) on ST-segment elevation myocardial infarction (STEMI).Methods The databases of PubMed (from 1994 to May 2014), EMbase (from 2000 to May 2014), Cochrane Library (No. 4 of 2012 Vol.), CBM (from 2004 to May 2014), CNKI (from 2004 to May 2014) and WanFang Database (from 2004 to May 2014) were retrieved with computer for searching the randomized controlled trials (RCT) about the curative effect and safety of transfemoral PCI on STEMI. All materials were given document screen, data extract and quality review by 2 reviewers according to inclusion and exclusion criteria, and then given a Meta-analysis by using RevMan5.2 software.Results There were finally 13 RCT included involving 5158 cases. The results of Meta-analysis showed that mortality (2.8%vs. 4.8%;OR: 0.56, 95%CI: 0.41~0.77;P<0.001), major bleeding incidence (1.3%vs.2.9%;OR: 0.48, 95%CI: 0.31~0.72;P<0.001), MACE incidence (4.6%vs. 6.8%;OR: 0.64, 95%CI: 0.50~0.83;P<0.001), puncture site complications (2.0%vs. 5.6%;OR: 0.34, 95%CI: 0.24~0.48;P<0.00001) and hospitalization days (SMD: 0.64; 95%CI: 0.50-0.83;P<0.05) decreased significantly in perradial PCI group compared with transfemoral PCI group. The difference in procedure success rate, X-ray exposure time, contrast agent dosage, re-infarction rate, stroke incidence and CABG rate had no statistical significance between 2 groups. The puncture time and procedure time were longer and incidence of changing puncture pathways was higher in perradial PCI group than those in transfemoral PCI group.Conclusion The perradial PCI is superior to transfemoral PCI in treatment of STEMI, and it can reduce mortality, major bleeding incidence, MACE and puncture site complications. Under the condition of fitting strictly indications and improving operators’ skills, perradial PCI is safe and effective, but the long-term
<br> curative effect and overall safety are needed to be confirmed with more large-sample and high-quality RCT.
Keywords：Radial arteryFemoral arteryST-segment elevation myocardial infarctionCoronary interventionMeta-analysis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 170-175,187 )