摘要
<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Most of the institutions accept the Transradial Access (TRA) as the first approach for patients undergoing Coronary Angiography (CAG) and Percutaneous Coronary Interventions (PCI). Several studies clearly revealed endothelial injury of coronary arteries triggers inflammatory response. In this study, we aimed to evaluate inflammatory respond to CAG and to compare the inflammatory response of TRA and Transfemoral Access (TFA). </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">In this single-center prospective study 140 consecutive patients presenting with (Chronical Coronary Syndrome) CCS and underwent transradial or transfemoral CAG between December 2017 and December 2018 were included. After exclusions, left 92 patients were divided into two equal groups as TRA and TFA. The primary endpoints were 2nd hour Tumor Necrosis Factor alpha (TNF</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">), 48</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> hour high-sensitivity C-Reactive Protein</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(hs-CRP), complication rates, amount of contrast medium, procedure time and fluoroscopy time. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Basal characteristics of TRA and TFA groups were similar. A comparison of variables demonstrated that there was no statistical significance in increase in inflammatory markers (TNF</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">, hs-CRP), complication rates, amount of contrast media and procedure time. In contrast, TRA was associated longer fluoroscopy time and higher X-ray dosage, although statistically insignificant. CAG caused a similar increase in hs-CRP in both groups, insignificantly. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In contrast to previous studies reporting a higher inflammatory response with TRA, this study demonstrates that inflammatory response caused by CAG is unrelated to access site and similar in TRA and TFA. Longer fluoroscopy time, higher X-ray dosage and longer procedure time in the TRA group indicate the importance of carefully selecting the angiographic route especially in patients with chronic heart failure, chronic renal impairment and malignancy risk. Also, these parameters place importance for physicians own health and woman planning pregnancy</span></span><span style="font-family:Verdana;">.</span>
<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Most of the institutions accept the Transradial Access (TRA) as the first approach for patients undergoing Coronary Angiography (CAG) and Percutaneous Coronary Interventions (PCI). Several studies clearly revealed endothelial injury of coronary arteries triggers inflammatory response. In this study, we aimed to evaluate inflammatory respond to CAG and to compare the inflammatory response of TRA and Transfemoral Access (TFA). </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">In this single-center prospective study 140 consecutive patients presenting with (Chronical Coronary Syndrome) CCS and underwent transradial or transfemoral CAG between December 2017 and December 2018 were included. After exclusions, left 92 patients were divided into two equal groups as TRA and TFA. The primary endpoints were 2nd hour Tumor Necrosis Factor alpha (TNF</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">), 48</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> hour high-sensitivity C-Reactive Protein</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(hs-CRP), complication rates, amount of contrast medium, procedure time and fluoroscopy time. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Basal characteristics of TRA and TFA groups were similar. A comparison of variables demonstrated that there was no statistical significance in increase in inflammatory markers (TNF</span><i><span style="font-family:Verdana;">α</span></i><span style="font-family:Verdana;">, hs-CRP), complication rates, amount of contrast media and procedure time. In contrast, TRA was associated longer fluoroscopy time and higher X-ray dosage, although statistically insignificant. CAG caused a similar increase in hs-CRP in both groups, insignificantly. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In contrast to previous studies reporting a higher inflammatory response with TRA, this study demonstrates that inflammatory response caused by CAG is unrelated to access site and similar in TRA and TFA. Longer fluoroscopy time, higher X-ray dosage and longer procedure time in the TRA group indicate the importance of carefully selecting the angiographic route especially in patients with chronic heart failure, chronic renal impairment and malignancy risk. Also, these parameters place importance for physicians own health and woman planning pregnancy</span></span><span style="font-family:Verdana;">.</span>
作者
Ozge Cetinarslan
Aysem Kaya
Alev Arat Ozkan
Ozge Cetinarslan;Aysem Kaya;Alev Arat Ozkan(Private Incirli Ethica Hospital, Istanbul, Turkey;Institute of Cardiology, University of Istanbul, Cerrahpasa, Turkey)