Different Antiplatelet Strategies for Radial Artery Protection After Transradial Coronary Angiography—A Prospective Observational Cohort Study

Frontiers in Cardiovascular Medicine

article

Zheng Qin¹  Xingsheng Yang¹  Wanjun Cheng²  Jianlong Wang²  Zening Jin¹ 

[1] Department of Cardiovascular, Beijing Tiantan Hospital, Capital Medical University;Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University

关键词: radial artery occlusion;    transradial access;    single-antiplatelet therapy;    dual-antiplatelet therapy;    coronary angiography;   

DOI  :  10.3389/fcvm.2022.913008

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Introduction Radial artery occlusion (RAO) after transradial access is a common thrombotic complication. A meta-analysis has proven that RAO incidence in transradial coronary angiography (TRCA) settings was significantly higher than that in percutaneous coronary intervention settings. This prospective observational cohort aimed to evaluate radial artery protection after TRCA with different antiplatelet strategies. Methods A total of 2,316 patients undergoing TRCA was enrolled and divided into two groups: single-antiplatelet and dual-antiplatelet groups. Radial artery patency was evaluated by ultrasound before, at 24 h, and 30 days after TRCA. The primary endpoint was RAO incidence at 30 days after TRCA. Results A total of 66 RAO was found on ultrasonography at 30-day follow-up (incidence: 2.8%). In the dual-antiplatelet group, the rate of RAO was significantly lower compared with the single-antiplatelet group (1.8 vs. 4.0%; odds ratio (OR): 0.41; 95% confidence interval (CI): 0.24–0.70; p = 0.001). The rate of self-recanalization in the dual-antiplatelet group was significantly higher than that in the single-antiplatelet group (73.68 vs. 44.12%, p < 0.001). However, there was no statistical difference in delayed occlusion of radial artery between the two groups (0.5 vs. 0.2%, p = 0.140). Unexpectedly, this study also showed no significant difference in bleeding risk between the groups. Conclusion Dual-antiplatelet therapy for 1 month after TRCA was associated with a reduced risk of RAO and deemed safe.

【 授权许可】

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