Abstract 16151: Comparison of Safety and Efficacy of Transradial versus Transfemoral Percutaneous Coronary Intervention for St Elevation Myocardial Infarction: A Meta-analysis of Randomized Controlled Trials

Abstract

Introduction: Studies have shown decreased rates of vascular complications and mortality with Transradial (TR) percutaneous coronary intervention approach for treating patients with acute ST elevation myocardial infarction (STEMI) compared to conventional Transfemoral (TF). Hypothesis: This meta-analysis aims to compare the safety and efficacy of TR vs TF approach in the light of recently published data. Methods: Electronic databases including MEDLINE, ClinicalTrials.gov and the Cochrane Library were searched for all randomized controlled trials (RCTs) published until April 2020 comparing outcomes of TR vs TF PCI in STEMI patients. End points were all-cause mortality, major bleeding, stroke, major adverse cardiac events (MACE), and vascular complications. The ratio risk ratio (RR) with 95% confidence interval (CI) were computed and p <0.05 was considered as a level of significance. Results: A total of 18 RCTs (n=13,516) were included in the final analysis. All-cause mortality (RR: 0.72; CI: 0.59-0.88; p=0.002), major bleeding (RR: 0.53; CI: 0.40-0.70; p<0.0001), MACE (RR: 0.78; CI: 0.69-0.88; p=0.0001), and vascular complications (RR: 0.42; CI: 0.33-0.53; p<0.00001) were decreased in the TR group [Figure 1]. There was a non-significant decrease risk of stroke in TF group (RR: 1.51; CI: 0.81-0.2.83; p=0.20) compared to TR group [Figure 1]. Conclusions: In patients with STEMI, all-cause mortality, MACE and vascular complications were decreased with TR compared to TF group. Further studies needed to confirm the findings of this meta-analysis.