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Comparison of Frequency of Silent Cerebral Infarction After Coronary Angiography and Stenting With Transradial Versus Transfemoral Approaches

The American journal of cardiology, 2018-08, Vol.122 (4), p.548-553 [Peer Reviewed Journal]

2018 Elsevier Inc. ;Copyright © 2018 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Aug 15, 2018 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2018.04.056 ;PMID: 29960662

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Title:
Comparison of Frequency of Silent Cerebral Infarction After Coronary Angiography and Stenting With Transradial Versus Transfemoral Approaches
Author: Göksülük, Hüseyin ; Güleç, Sadi ; Özyüncü, Nil ; Kürklü, Seda Tan ; Vurgun, Veysel Kutay ; Candemir, Başar ; Uludağ, Menekşe Gerede ; Öztürk, Semih ; Us, Ebru ; Erol, Çetin
Subjects: Acute Coronary Syndrome - diagnosis ; Acute Coronary Syndrome - surgery ; Age ; Angiography ; Body mass index ; Cardiac Catheterization - adverse effects ; Catheters ; Cerebral infarction ; Cerebral Infarction - epidemiology ; Cerebral Infarction - etiology ; Cholesterol ; Confidence intervals ; Coronary Angiography - adverse effects ; Coronary vessels ; Diabetes ; Diagnostic systems ; Female ; Femoral Artery ; Follow-Up Studies ; Heart attacks ; Humans ; Hyperlipidemia ; Hypertension ; Incidence ; Intervention ; Intubation ; Male ; Medical imaging ; Middle Aged ; Multivariate analysis ; Myocardial infarction ; Nervous system ; Patients ; Percutaneous Coronary Intervention - adverse effects ; Phosphopyruvate hydratase ; Radial Artery ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Sexuality ; Smoking ; Stents ; Stroke ; Surgery ; Turkey - epidemiology ; Variables ; Veins & arteries
Is Part Of: The American journal of cardiology, 2018-08, Vol.122 (4), p.548-553
Description: Silent cerebral infarction (SCI) can be seen after coronary procedures. We investigated whether vascular access sites have an impact on the risk of SCI. A total of 255 consecutive patients who underwent diagnostic or interventional coronary procedures through transfemoral (n = 126 patients) or transradial (n = 129 patients) approach were evaluated. Neuron-specific enolase (NSE) levels were studied before and 12 hours after the procedure. Elevation of greater than 12 ng/ml was considered as SCI. Patients were mainly men (60%) with a mean age of 62 years. SCI was observed in 74 of 255 patients (29%). It was significantly more prevalent among transradial group. Elevation of NSE was observed in 36% of transradial group (n = 47) and 21% of the transfemoral group (n = 27) (p = 0.008). Patients with SCI were more likely to have male sexuality, hyperlipidemia, history of smoking, and previous myocardial infarction. Multivariate analysis demonstrated that patients who underwent coronary procedures through transradial approach were 2.1 times more likely to have an SCI than patients with transfemoral approach (95% confidence interval [CI] 1.205 to 3.666; p = 0.008). Other independent predictors of NSE elevation were previous myocardial infarction (odds ratio 8.6; 95% CI 4.209 to 17.572; p <0.001) and smoking history (odds ratio 7.251; 95% CI 3.855 to 13.639; p <0.001). The present study suggests that transradial coronary procedures carry higher risk of SCI when compared with transfemoral route.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2018.04.056
PMID: 29960662
Source: MEDLINE
ProQuest Central

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Comparison of Frequency of Silent Cerebral Infarction After Coronary Angiography and Stenting With Transradial Versus Transfemoral Approaches

2018 Elsevier Inc. ;Copyright © 2018 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Aug 15, 2018 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2018.04.056 ;PMID: 29960662

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