Safety and efficacy of femoral access vs radial access in ST-segment elevation myocardial infarction: The SAFARI-STEMI randomized clinical trial
JAMA Cardiology Feb 26, 2020
Le May M, Wells G, So D, et al. - By performing this multicenter, open-label, randomized clinical trial, researchers investigated if the use of radial access instead of femoral access affords a survival benefit in patients with ST-segment elevation myocardial infarction referred for primary percutaneous coronary intervention (PCI). This inquiry was undertaken at 5 PCI centers in Canada. Overall, 2,292 patients were enrolled, with a 30-day follow-up. Among 1,136 patients in the radial access group and 1,156 patients in the femoral access group, primary PCI was received by 1,082 (95.2%) and by 1,109 (95.9%) patients, respectively. In 17 patients (1.5%) treated using radial access and in 15 patients (1.3%) assigned to femoral access, the occurrence of primary outcome ie, 30-day all-cause mortality, was documented. In terms of the rates of reinfarction, stroke, and bleeding, no significant differences existed between patients assigned to radial and femoral access. Overall, findings revealed no significant differences in terms of survival or other clinical endpoints at 30 days following the use of radial access vs femoral access in this patient population. However, small absolute variations in endpoints cannot be definitively denied given the premature end of the trial.
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