Abstract 15001: Radial Access Has No Impact on Medications Adherence Post Coronary Intervention: A Retrospective Observational Cohort Study Using Real-world Data

Abstract

Introduction: The Transradial artery access for Primary Percutaneous Coronary Intervention (PCI) is the preferred access for coronary interventions in ST Elevation Myocardial Infarction STEMI due to less complications post intervention and it has been shown to improve quality of life of patients post intervention. This decrease in complications may give the patient sense of ease and underestimation of disease severity, and hence worsen the patient’s compliance with medications. This retrospective observation study aimed to assess the impact of radial versus femoral access coronary interventions on adherence to post-PCI medications. Methods: We conducted a retrospective analysis for all patients who presented with STEMI and underwent primary PCI in a tertiary cardiac hospital in Qatar between January 1, 2016 and December 31, 2018. Adherence was assessed by refilling the first prescription post discharge. Adherence rates were compared between the patients who underwent PCI with radial versus femoral access using the Chi square test. Results: A total of 1339 patients who presented with acute STEMI and underwent primary PCI were included in our retrospective analysis. The majority of patients included were male (96%) with mean age of 51 years. The majority of patients (1082; 81%) underwent radial access, while 257 (19%) underwent femoral access. The two groups were comparable in terms of age, nationality, the presence of full versus partial insurance, and using medications before admission. The patients adherence to medications post-PCI, including aspirin, P2Y12 inhibitor, statin, beta-blocker, angiotensin converting enzyme (ACE) inhibitor/ angiotensin II receptor blocker (ARB) was comparable between the radial versus femoral access ( aspirin: 78% vs. 74%; p-value= 0.16, P2Y12 inhibitor: 81% vs. 79%; p-value=0.45, statin: 80% vs. 76%; p-value= 0.15, beta-blocker: 72% vs. 70; p-value= 0.51, ACE inhibitor/ARB: 79% vs. 74%; p-value= 0.09). Conclusion: In comparison to femoral access in primary coronary intervention in STEMI, the radial access resulted in similar adherence to post-PCI medications assessed by refilling of first prescription post discharge. Therefore, the radial access is a safe approach in terms medications adherence.