AUTHOR=Guo Jincheng , Wang Guozhong , Li Zixuan , Liu Zijing , Wang Yujie , Wang Senhu , Wang Yuntao , Wu Yongxia , Wang Haotian , Wang Yuping , Zhang Libin , Hua Qi 

TITLE=Culprit vessel revascularization first with primary use of a dedicated transradial guiding catheter to reduce door to balloon time in primary percutaneous coronary intervention

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1022488

DOI=10.3389/fcvm.2022.1022488

ISSN=2297-055X

ABSTRACT=Background The effect of a single transradial guiding catheter (STGC) for culprit vessel percutaneous coronary intervention (PCI) first on door-to-balloon (D2B) time remains unclear.
Methods Between February 2017 and July 2019, 560 patients with ST-elevation myocardial infarction (STEMI) were randomized to either an STGC group (n=280) or a control group (n=280) according to direct culprit vessel PCI with an STGC. The primary endpoint was D2B time, and the secondary endpoint included catheterization laboratory door-to-balloon (C2B), procedural, fluoroscopy times, and major adverse cardiac events (MACE) at 30 days.
Results The median D2B time was significantly shorter in the STGC group compared to the control group (53.9 vs. 58.4 min; p=0.003). The C2B, procedural, and fluoroscopy times were also shorter in the STGC group (C2B: 17.3 vs. 24.5 min, p<0.001; procedural: 45.2 vs. 49.0 min, p=0.012; fluoroscopy: 9.7 vs. 11.3 min, p=0.025). More patients achieved the goal of D2B time within 90 min (93.9% vs. 87.1%, p=0.006) and 60 min (61.4% vs. 51.1%, p=0.013) in the STGC group. Radial artery perforation was significantly reduced in STGC group compared with control group (0.7% vs. 3.2%, P=0.033). MACE at 30 days was similar (2.5% vs. 4.6%, P=0.172) between two groups.
Conclusions Electrocardiogram-guided immediate intervention on culprit vessel with an STGC can reduce D2B, C2B, procedural, and fluoroscopy times. (ECG-guided Immediate Primary PCI for Culprit Vessel to Reduce Door to Device Time; NCT03272451).