Assessing the Viability of Using Radial Artery Access for Primary Angioplasty and Doing a Subgroup Analysis on High-Risk Patients - A Significant Change in Approach

Abstract

Aim:Assessing the viability of using radial artery access for primary angioplasty and doing a subgroup analysis on high-risk patients.

Materials and methods: The study consisted of 100 patients who were diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and had percutaneous coronary intervention (PCI) via the radial artery (RA) at the cardiology department. Patients were hospitalized and assessed for initial features such as medical history, physical examination, and diagnostic tests including ECG, 2D echo, and normal laboratory investigation. Subsequently, the patients were categorized into two distinct groups, namely Group A (HRG) and Group B (non HRG), in order to conduct a more detailed study of subgroups.

Results:The average systolic blood pressure of the patients upon presentation was 141.03 ± 8.34 mmHg, whereas the average diastolic blood pressure was 84.21 ± 5.54 mmHg. The study group had a total ischaemic time of 6.53 ± 1.44 hours. Upon analyzing the ECG, it was observed that 50% of the cases exhibited AWMI. Additionally, 5% of the cases showed a pattern known as QRBBB, while 51% IWMI. Furthermore, 4% of the cases presented with RVMI. During the echocardiography examination, it was found that 23% of the individuals had a satisfactory left ventricular (LV) function, with a left ventricular ejection fraction (LVEF) more than 50%. Additionally, 40% had a mild LV systolic dysfunction, with an LVEF ranging from 40% to 50%. Furthermore, 17% had a moderate LV systolic dysfunction, with an LVEF ranging from 30% to 40%. Lastly, 20% had a severe LV systolic dysfunction, with an LVEF less than 30%.

Conclusion: When comparing HRG and NON-HRG, there were more difficulties in HRG, however the difference was not statistically significant (p value > 0.05). There was no notable disparity in procedural factors between the two groups.