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RIFLE STEACS: Radial approach may be preferable to femoral approach in STEMI patients

Issue: December 2011

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TCT 2011

SAN FRANCISCO — A transradial approach to angioplasty may be more effective than the femoral approach in patients with ST elevation acute coronary syndrome, according to results of the RIFLE STEACS trial that were presented by Enrico Romagnoli, MD, PhD, of Policlinico Casilino in Rome, at the 2011 Transcatheter Cardiovascular Therapeutics scientific symposium..

There were 1,001 STEMI patients randomly assigned to radial or femoral access in a 1:1 ratio. The primary outcome measure was the rate of net adverse clinical events at 30 days. The endpoint included a composite of cardiac death, MI, stroke, target lesion revascularization or non-CABG-related major bleeding. Secondary endpoints were individual components of the composite.

Results at 30 days indicated that the rate of the composite endpoint was 13.6% in the radial group and 21% in the femoral group. A reduction in major adverse cardiac and cerebrovascular events was also observed in the radial group, 7.2% vs. 11.4%, as was a reduction in bleeding, 7.8% vs. 12.2%.

The 30-day rate of cardiac death was 9.2% in the femoral group and 5.2% in the radial group.

"Radial access in patients with (ST elevation acute coronary syndrome [STEACS]) is associated with significant clinical benefits, in terms of both lower morbidity and mortality," Romagnoli said. "A radial approach should, thus, no more be considered a valid alternative to a femoral one, but become the recommended access site for STEACS."

The aim of the prospective, randomized, parallel group, multicenter trial was to determine which approach would yield better outcomes in patients with STEACS.

The study was conducted from January 2009 to July 2011 in Italy.

Disclosure: Disclosure: Dr. Romagnoli reports no relevant financial disclosures.

For more information:

• Romagnoli R. Plenary Session XIII. Late-Breaking Clinical Trials and First Report Investigations II. Presented at: the 2011 Transcatheter Cardiovascular Therapeutics Scientific Symposium; Nov. 7-11; San Francisco.

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