Chinese Medical Sciences Journal ›› 2017, Vol. 32 ›› Issue (3): 161-170.doi: 10.24920/J1001-9294.2017.023

• Orginal Article • Previous Articles     Next Articles

Transradial Versus Transfemoral Approach for Percutaneous Coronary Intervention in Elderly Patients in China: A Retrospective Analysis

Jin Chen?, Xu Yi?, Qiao Shu-bin, Tang Xin-ran, Wu Yong-jian, Yan Hong-bing, Dou Ke-fei, Xu Bo, Yang Jin-gang, Yang Yue-jin*()   

  1. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
  • Received:2016-12-07 Online:2017-09-26 Published:2017-09-27
  • Contact: Jin Chen,Xu Yi,Yang Yue-jin E-mail:yangyjfw@126.com

Abstract: Objective

To compare hospital costs and clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients aged over 65 years.

Methods

We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention (PCI) in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control potential biases.

Results

Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 (95%CI: CNY4419-10 420). Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay (1.9 days, 95%CI: 1.1-2.7 days), shorter post-procedural stay (0.7 days, 95%CI: 0.3-1.1 days), and fewer major adverse cardiac events (adjusted odds ratio = 0.47, 95%CI: 0.31-0.73). There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI (P>0.05). Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina.

Conclusion

The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.

Key words: coronary artery disease, cost-benefit analysis, percutaneous coronary intervention, aged, transradial intervention, transfemoral intervention

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