Impact of Sex on Outcomes With Femoral Artery Closure Devices Versus Manual Compression in Patients Undergoing Percutaneous Coronary Intervention

被引：0

作者：

Anderson, Wesley L. ^{[1
]}

Torabi, Asad J. ^{[1
]}

O'leary, Brian A. ^{[1
]}

Breall, Jeffrey A. ^{[1
]}

Sinha, Anjan K. ^{[1
]}

Jaradat, Ziad A. ^{[1
]}

Morris, Michelle C. ^{[1
]}

Frick, Kyle A. ^{[1
]}

Romeh, Ibrahim A. ^{[1
]}

Iqtidar, Ali F. ^{[1
]}

von der Lohe, Elisabeth ^{[1
]}

Kreutz, Rolf P. ^{[1
]}

机构：

[1] Indiana Univ Sch Med, Dept Med, Div Cardiovasc Med, Indianapolis, IN 46202 USA

来源：

HEALTH SCIENCE REPORTS | 2024年 / 7卷 / 12期

关键词：

bleeding; cardiac catheterization; percutaneous coronary intervention; sex; women; vascular closure devices; SUTURE-MEDIATED CLOSURE; VASCULAR COMPLICATIONS; ACCESS; CATHETERIZATION; ACTIVATION; EVENTS; GENDER; WOMEN; SITE;

D O I：

10.1002/hsr2.70256

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background and AimsFemoral artery access is widely used despite recent increase in radial access for percutaneous coronary interventions (PCI). Femoral artery closure devices are used to shorten vascular closure time and reduce bleeding. We sought to examine sex-based outcomes of femoral artery vascular closure devices (VCD) in patients undergoing PCI. MethodsWe identified patients who had undergone PCI (n = 11,415) in the Indiana University Health Multicenter Cardiac Cath registry using femoral artery access. Clinical outcomes were compared between VCD and manual compression and analyzed according to sex. Patients with cardiogenic shock and left ventricular support devices were excluded. ResultsThe use of any vascular closure device as compared to femoral artery manual compression was associated with a reduction in 72-h bleeding events (adjusted odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.46-0.87). With manual compression, women had higher rates of 72-h bleeding as compared to men (4.5% vs. 1.6%, p < 0.001). Women demonstrated greater absolute risk reduction in 72-h bleeding events with use of VCD as compared to men (2.8% vs. 0.8%, p < 0.001). For women, VCD were associated with lower risk of access site bleeding (OR: 0.43; 95% CI: 0.24-0.8), hematoma (OR: 0.36; 95% CI: 0.2-0.63), and vascular complications (OR: 0.25, 95% CI: 0.09-0.72). Use of VCD was associated with lower risk of in-hospital death (adjusted OR: 0.4; 95% CI: 0.28-0.58; p < 0.001) in multivariable regression analysis. ConclusionWomen derive more benefit from use of femoral artery VCD during PCI than men with greater reduction in bleeding rates, access site hematoma, and vascular complications.

引用

页数：9

共 34 条

[1]

Vaduganathan M., Harrington R., Stone G., Et al., Short-and Long-Term Mortality Following Bleeding Events in Patients Undergoing Percutaneous Coronary Intervention: Insights From Four Validated Bleeding Scales in the CHAMPION Trials, EuroIntervention, 13, pp. e1841-e1849, (2018)

[2]

Mehran R., Pocock S., Nikolsky E., Et al., Impact of Bleeding on Mortality After Percutaneous Coronary Intervention: Results From a Patient-Level Pooled Analysis of the REPLACE-2 (Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events), ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy), and HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) Trials, JACC Cardiovascular Interventions, 4, pp. 654-664, (2011)

[3]

Feldman D.N., Swaminathan R.V., Kaltenbach L.A., Et al., Adoption of Radial Access and Comparison of Outcomes to Femoral Access in Percutaneous Coronary Intervention: An Updated Report From The National Cardiovascular Data Registry (2007-2012), Circulation, 127, pp. 2295-2306, (2013)

[4]

Gargiulo G., Giacoppo D., Jolly S.S., Et al., Effects on Mortality and Major Bleeding of Radial Versus Femoral Artery Access for Coronary Angiography or Percutaneous Coronary Intervention: Meta-Analysis of Individual Patient Data From 7 Multicenter Randomized Clinical Trials, Circulation, 146, pp. 1329-1343, (2022)

[5]

Idris H., French J.K., Shugman I.M., Hopkins A.P., Juergens C.P., Thomas L., Influence of Age and Gender on Clinical Outcomes Following Percutaneous Coronary Intervention for Acute Coronary Syndromes, Heart, Lung and Circulation, 26, pp. 554-565, (2017)

[6]

Yu J., Mehran R., Grinfeld L., Et al., Sex-Based Differences in Bleeding and Long Term Adverse Events After Percutaneous Coronary Intervention for Acute Myocardial Infarction: Three Year Results From the HORIZONS-AMI Trial, Catheterization and Cardiovascular Interventions, 85, pp. 359-368, (2015)

[7]

Numasawa Y., Kohsaka S., Miyata H., Et al., Gender Differences in In-Hospital Clinical Outcomes After Percutaneous Coronary Interventions: An Insight From a Japanese Multicenter Registry, PLoS One, 10, (2015)

[8]

Chester R.C., Mina S.A., Lewis B., Zhang N., Butterfield R., Yang E.H., Radial Artery Access Is Under-Utilized in Women Undergoing PCI Despite Potential Benefits: Mayo Clinic PCI Registry, Catheterization and Cardiovascular Interventions, 95, pp. 675-683, (2020)

[9]

Essibayi M.A., Cloft H., Savastano L.E., Brinjikji W., Safety and Efficacy of Angio-Seal Device for Transfemoral Neuroendovascular Procedures: A Systematic Review and Meta-Analysis, Interventional Neuroradiology, 27, pp. 703-711, (2021)

[10]

Nikolsky E., Mehran R., Halkin A., Et al., Vascular Complications Associated With Arteriotomy Closure Devices in Patients Undergoing Percutaneous Coronary Procedures: A Meta-Analysis, Journal of the American College of Cardiology, 44, pp. 1200-1209, (2004)

← 1 2 3 4 →