Conference Coverage

Radial access PCI best for acute coronary syndrome patients



– Radial access should be the preferred approach to percutaneous interventions in acute coronary syndromes in the United States as it is now in Europe, according to an investigator whose data from a randomized trial substudy was the topic of a late-breaker presentation at CRT 2018 sponsored by the Cardiovascular Research Institute at Washington Hospital Center..

It was not just these data, but “the totality of the evidence supports radial access as the first choice in PCI [percutaneous intervention] for acute coronary events,” asserted Elmir Omerovic, MD, professor of cardiology at Sahlgrenska University Hospital, Gothenburg, Sweden.

The data for the prespecified substudy was drawn from the VALIDATE-SWEDEHEART trial, published 6 months ago (N Engl J Med 2017;377:1132-42). In that trial, which randomized patients with ACS undergoing PCI to heparin or bivalirudin, there was no difference between anticoagulation strategies for the primary composite endpoint of death from any cause, myocardial infarction or bleeding from any cause.

Of the 6,006 randomized patients in that study, of which about half had an ST-elevation MI and half had a non–ST-elevation MI event, 5,424 (90%) underwent PCI by the radial route and the remainder by the femoral route. The goal of the prespecified subgroup analysis presented by Dr. Omerovic was to evaluate whether choice of access site had an impact on the primary endpoint or its components.


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