SynthesisPloS one2014
Transradial versus transfemoral approach in patients undergoing percutaneous coronary intervention for acute coronary syndrome. A meta-analysis and trial sequential analysis of randomized controlled trials.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Mortality after bleeding versus myocardial infarction in coronary artery disease: a systematic review and meta-analysis.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Pooled it
- Pooled it
- Different Approaches for Cerebral Angiography: Distal Radial Artery or Proximal Radial Artery? A Single-Center, Non-Blinded, Randomized Controlled Study.Health science reports · 2026Article
- Management of Non-Culprit Lesions in STEMI Patients with Multivessel Disease.Journal of clinical medicine · 2023Review
- Clinical predictors and management for radial artery spasm: an Australian cross-sectional study.BMC cardiovascular disorders · 2023Article
- A reality check in transradial access: a single-centre comparison of transradial and transfemoral access for abdominal and peripheral intervention.European radiology · 2019Article
- Unfractionated Heparin with Sequential Enoxaparin in Patients with Complex Coronary Artery Lesions during Percutaneous Coronary Intervention.Chinese medical journal · 2018Article
- Novel Patient-Centered Approach to Facilitate Same-Day Discharge in Patients Undergoing Elective Percutaneous Coronary Intervention.Journal of the American Heart Association · 2018Article
- Novel treatments for in-stent restenosis: sirolimus-eluting balloons enter the arena.Journal of thoracic disease · 2018Article
- Coronary artery disease and myocardial revascularization in patients undergoing transcatheter aortic valve replacement.Journal of thoracic disease · 2017Article
- Transradial Approach in Primary Percutaneous Coronary Intervention: Lessons from a High-volume Centre.Interventional cardiology (London, England) · 2016Article
- Medicolegal implications of radial and femoral access for coronary angiography and intervention in 2016: Focus on retroperitoneal hemorrhage.Journal of translational internal medicine · 2016Article
- Radial Interventions: Present and Future Indications.Current treatment options in cardiovascular medicine · 2016Article
- Hand ischaemia after radial artery cannulation.BMJ case reports · 2015Article
- Risk factors of failed transradial approach for percutaneous coronary interventions in Chaoshan Chinese: a locally retrospective analysis.International journal of clinical and experimental medicine · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransfemoral approach (TFA) remains the most common vascular access for percutaneous coronary intervention (PCI) in many countries. However, in the last years several randomized trials compared transradial approach (TRA) with TFA in patients with acute coronary syndrome (ACS), but only few studies were powered to estimate rare events. The aim of the current study was to clarify whether TRA is superior to TFA approach in patients with ACS undergoing percutaneous coronary intervention. A meta-analysis, meta-regression and trial sequential analysis of safety and efficacy of TRA in ACS setting was performed. METHODS AND
resultsMedline, the Cochrane Library, Scopus, scientific session abstracts and relevant websites were searched. Data concerning the study design, patient characteristics, risk of bias, and outcomes were extracted. The primary endpoint was death. Secondary endpoints were: major bleeding and vascular complications. Outcomes were assessed within 30 days. Eleven randomized trials involving 9,202 patients were included. Compared with TFA, TRA significantly reduced the risk of death (odds ratio [OR] 0.70; 95% confidence interval [CI], 0.53-0.94; p = 0.016), but this finding was not confirmed in trial sequential analysis, indicating that sufficient evidence had not been yet reached. Furthermore, TRA compared with TFA reduced the risk of major bleeding (OR 0.60; 95% CI, 0.41-0.88; p = 0.008) and vascular complications (OR 0.35; 95% CI, 0.28-0.46; p<0.001); these findings were supported by trial sequential analyses.
conclusionsIn patients with ACS undergoing PCI, a lower risk of death was observed with TRA. Nevertheless, the association between mortality and TRA in ACS setting should be interpreted with caution because it is based on insufficient evidence. However, because of the clinical relevance associated with major bleeding and vascular complications reduction, TRA should be recommended as first-choice vascular access in patients with ACS undergoing cardiac catheterization.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.