Impact of transradial coronary intervention on bleeding complications in octogenarians.

Abstract

Percutaneous coronary intervention (PCI) in the elderly is a major hospital burden since this group of patients exhibits high mortality rates and many comorbidities. The aim of this study was to analyze the impact of a transradial intervention (TRI) approach for PCI on bleeding complications in octogenarians. We retrospectively analyzed a consecutive cohort of 2530 patients who underwent PCI at a tertiary care center in Japan. Octogenarians constituted 12% (291 cases) of the total PCI cases during the study period. Bleeding complications and all-cause mortality were observed at 30days after PCI. Average age was 83±3years and female gender was 32%. Stable coronary artery disease was 59%. TRI was performed in 218 patients (75%) and transfemoral intervention (TFI) in 73 (25%). Bleeding Academic Research Consortium (BARC) major bleeding unrelated to bypass surgery were observed in 7.6%, which were significantly lower in TRI than TFI (5.1 vs. 15.1%, P=0.005). The 30-day mortality rate was significantly low in patients without bleeding (4.9 vs. 31%, p<0.0001). In octogenarians, major bleeding complication was significant at 30days after PCI. TRI had lower bleeding complication rate than TFI in this population. Octogenarians may be a subgroup of patients who derive benefits from TRI.