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RIFLE-STEACS: Radial access improved outcomes in ACS patients
Patients with ST-elevation ACS who underwent PCI boasted better outcomes when radial access was used instead of femoral access, according to results from the first large, randomized trial comparing the two approaches.
For the multicenter, parallel-group Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome (RIFLE-STEACS) study, Enrico Romagnoli, MD, PhD, of Policlinico Casilino in Rome, and colleagues randomly assigned 1,001 acute ST-segment elevation ACS patients undergoing primary or rescue PCI to the radial (n=500) or femoral (n=501) approach. Primary endpoint was the 30-day rate of net adverse clinical events, which was a composite of cardiac death, stroke, MI, target lesion revascularization and bleeding.
At 30 days, the rate of net adverse clinical events was significantly lower in the radial group vs. the femoral group (13.6% vs. 21%; P=.003). Additionally, compared with the femoral arm, the radial arm had considerably lower rates of cardiac mortality (5.2% vs. 9.2%; P=.02) and bleeding (7.8% vs. 12.2%; P=.026). Hospital stay was also shorter for patients in the radial group (5 days vs. 6 days; P=.03).
No significant differences in MI, target lesion revascularization and stroke were noted between groups.
These results, which were initially presented at TCT 2011, suggest that the radial approach “should become the recommended approach in [ST-elevation ACS] patients, provided adequate operator and center expertise is present,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.