Procedural Volume and Outcomes with Radial or Femoral access for coronary angiography and intervention
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F14%3A43908086" target="_blank" >RIV/00216208:11120/14:43908086 - isvavai.cz</a>
Result on the web
<a href="http://dx.doi.org/10.1016/j.jacc.2013.10.052" target="_blank" >http://dx.doi.org/10.1016/j.jacc.2013.10.052</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.jacc.2013.10.052" target="_blank" >10.1016/j.jacc.2013.10.052</a>
Alternative languages
Result language
angličtina
Original language name
Procedural Volume and Outcomes with Radial or Femoral access for coronary angiography and intervention
Original language description
To evaluate the relationship between procedural volume and outcomes with radial and femoral approach. BACKGROUND: RIVAL was a randomized trial of radial vs. femoral access for coronary angiography/ intervention (N=7021) which overall did not show a difference in primary outcome of death, MI, stroke or non-CABG major bleeding. METHODS: In pre-specified subgroup analyses, the hazard ratios for the primary outcome were compared i) among centres divided by tertiles and ii) among individual operators. A multivariable cox proportional hazards model was used to determine the independent effect of centre and operator volumes after adjusting for other variables. RESULTS: In high volume radial centres, the primary outcome was reduced with radial vs. femoral access (hazard ratio (HR) 0.49; 95%CI 0.28-0.87) but not in intermediate (HR 1.23; 95%CI 0.88-1.72) or low volume centres (HR 0.83; 95%CI 0.52-1.31); interaction p=0.021. High volume centres enrolled a higher proportion of STEMI. After adjustment for STEMI, the benefit of radial persisted at high volume radial centers. There was no difference in the primary outcome between radial and femoral access by operator volume: high volume operators (HR 0.79; 95%CI 0.48-1.28), intermediate (HR 0.87; 95%CI 0.60-1.27) and low (HR 1.10; 95%CI0.74-1.65); interaction p=0.536. However, in a multivariable model, overall centre volume and radial centre volume were independently associated with the primary outcome but not femoral centre volume (overall PCI volume HR 0.92; 95%CI 0.88-0.96, radial volume HR 0.88; 95%CI0.80-0.97 and femoral volume HR 1.00; 95%CI 0.94-1.07, p=0.98). CONCLUSIONS: Procedural volume and expertise are important, particularly for radial PCI.
Czech name
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Czech description
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Classification
Type
J<sub>x</sub> - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)
CEP classification
FA - Cardiovascular diseases including cardio-surgery
OECD FORD branch
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Result continuities
Project
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Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2014
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of the American College of Cardiology
ISSN
0735-1097
e-ISSN
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Volume of the periodical
63
Issue of the periodical within the volume
10
Country of publishing house
US - UNITED STATES
Number of pages
10
Pages from-to
954-963
UT code for WoS article
000332529400003
EID of the result in the Scopus database
2-s2.0-84896097881