{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:19:33Z","timestamp":1760300373946,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Heart and Vascular Institute Center for Healthcare Delivery Innovation, Cleveland Clinic"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to study adoption of transradial primary percutaneous coronary intervention (TR\u2010PPCI) for ST elevation myocardial infarction (STEMI) (\u201cradial first\u201d approach) and its association with door\u2010to\u2010balloon time (D2BT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>TR\u2010PPCI for STEMI is underutilized in the United States due to concerns about prolonging D2BT. Whether operators and hospitals adopting a radial first approach in STEMI incur prolonged D2BT is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 1,272 consecutive cases of STEMI with PPCI at our hospital from January 1, 2011, to December 31, 2016, we studied TR\u2010PPCI adoption and its association with D2BT including a propensity matched analysis of similar risk TR\u2010PPCI and trans\u2010femoral primary PCI (TF\u2010PPCI) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With major increases in hospital\u2010level TR\u2010PPCI (hospital TR\u2010PPCI rate: 2.6% in 2011 to 79.4% in 2016, <jats:italic>p<\/jats:italic>\u2010trend&lt;.001) and operator\u2010level TR\u2010PPCI (mean operator TR\u2010PPCI rate: 2.9% in 2011 to 81.1% in 2016, <jats:italic>p<\/jats:italic>\u2010trend = .005), median hospital level D2BT decreased from 102\u2009min [81, 142] in 2011 to 84\u2009min [60, 105] in 2016 (<jats:italic>p<\/jats:italic>\u2010trend&lt;.001). TF crossover (10.3%; <jats:italic>n<\/jats:italic> = 57) was not associated with unadjusted D2BT (TR\u2010PPCI success 91\u2009min [72, 112] vs. TF crossover 99\u2009min [70, 115], <jats:italic>p<\/jats:italic> = .432) or D2BT adjusted for study year and presenting location (7.2% longer D2BT with TF crossover, 95% CI: \u22124.0% to +18.5%, <jats:italic>p<\/jats:italic> = .208). Among 273 propensity\u2010matched pairs, unadjusted D2BT (TR\u2010PPCI 98 [78, 117] min vs. TF\u2010PPCI 101 [76, 132] min, <jats:italic>p<\/jats:italic> = .304), and D2BT adjusted for study year and presenting location (5.0% shorter D2BT with TR\u2010PPCI, 95% CI: \u221212.4% to +2.4%, <jats:italic>p<\/jats:italic> = .188) were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TR\u2010PPCI can be successfully implemented without compromising D2BT performance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28785","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T14:57:45Z","timestamp":1582815465000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of adoption of transradial access for percutaneous coronary intervention in ST elevation myocardial infarction with door\u2010to\u2010balloon time"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0151-5471","authenticated-orcid":false,"given":"Chetan P.","family":"Huded","sequence":"first","affiliation":[{"name":"Heart and Vascular Institute Center for Healthcare Delivery Innovation Cleveland Clinic  Cleveland Ohio"},{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-3391","authenticated-orcid":false,"given":"Samir R.","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jad A.","family":"Ballout","sequence":"additional","affiliation":[{"name":"Medicine Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6048-7955","authenticated-orcid":false,"given":"Amar","family":"Krishnaswamy","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6239-9772","authenticated-orcid":false,"given":"Stephen G.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Raymond","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Cho","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conrad","family":"Simpfendorfer","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Bajzer","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Martin","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Nair","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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