TUZIL, Jan, Jan MATEJKA, Mamas A A MAMAS a Tomáš DOLEŽAL. Short-term risk of periprocedural stroke relative to radial vs. femoral access: systematic review, meta-analysis, study sequential analysis and meta-regression of 2,188,047 real-world cardiac catheterizations. EXPERT REVIEW OF CARDIOVASCULAR THERAPY. PHILADELPHIA: TAYLOR & FRANCIS INC, 2023, roč. 21, č. 4, s. 293-304. ISSN 1477-9072. Dostupné z: https://dx.doi.org/10.1080/14779072.2023.2187378. |
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@article{2368545, author = {Tuzil, Jan and Matejka, Jan and Mamas, Mamas A A and Doležal, Tomáš}, article_location = {PHILADELPHIA}, article_number = {4}, doi = {http://dx.doi.org/10.1080/14779072.2023.2187378}, keywords = {Stroke; catheterization; radial; femoral; incidence; observational; cohort; real-world; accession site; meta-analysis; meta-regression; trial sequential analysis}, language = {eng}, issn = {1477-9072}, journal = {EXPERT REVIEW OF CARDIOVASCULAR THERAPY}, title = {Short-term risk of periprocedural stroke relative to radial vs. femoral access: systematic review, meta-analysis, study sequential analysis and meta-regression of 2,188,047 real-world cardiac catheterizations}, url = {https://www.tandfonline.com/doi/full/10.1080/14779072.2023.2187378}, volume = {21}, year = {2023} }
TY - JOUR ID - 2368545 AU - Tuzil, Jan - Matejka, Jan - Mamas, Mamas A A - Doležal, Tomáš PY - 2023 TI - Short-term risk of periprocedural stroke relative to radial vs. femoral access: systematic review, meta-analysis, study sequential analysis and meta-regression of 2,188,047 real-world cardiac catheterizations JF - EXPERT REVIEW OF CARDIOVASCULAR THERAPY VL - 21 IS - 4 SP - 293-304 EP - 293-304 PB - TAYLOR & FRANCIS INC SN - 14779072 KW - Stroke KW - catheterization KW - radial KW - femoral KW - incidence KW - observational KW - cohort KW - real-world KW - accession site KW - meta-analysis KW - meta-regression KW - trial sequential analysis UR - https://www.tandfonline.com/doi/full/10.1080/14779072.2023.2187378 N2 - ObjectivesTo verify whether transradial (TRA) compared to transfemoral (TFA) cardiac catheterization reduces the risk of periprocedural stroke (PS).MethodsWe reviewed (CRD42021277918) published real-world cohorts reporting the incidence of PS within 3 days following diagnostic or interventional catheterization. Meta-analyses and meta-regressions of odds ratios (OR) performed using the DerSimonian and Laird method were checked for publication bias (Egger test) and adjusted for false-positive results (study sequential analysis SSA).ResultsThe pooled incidence of PS from 2,188,047 catheterizations (14 cohorts), was 193 (105 to 355) per 100,000. Meta-analyses of adjusted estimates (OR = 0.66 (0.49 to 0.89); p = 0.007; I-2 = 90%), unadjusted estimates (OR = 0.63 (0.51 to 0.77; I-2 = 74%; p = 0.000)), and a sub-group of prospective cohorts (OR = 0.67 (0.48 to 0.94; p = 0.022; I-2 = 16%)) had a lower risk of PS in TRA (without indication of publication bias). SSA confirmed the pooled sample size was sufficient to support these conclusions. Meta-regression decreased the unexplained heterogeneity but did not identify any independent predictor of PS nor any effect modifier.ConclusionPeriprocedural stroke remains a rare and hard-to-predict adverse event associated with cardiac catheterization. TRA is associated with a 20% to 30% lower risk of PS in real-world/common practice settings. Future studies are unlikely to change our conclusion. ER -
TUZIL, Jan, Jan MATEJKA, Mamas A A MAMAS a Tomáš DOLEŽAL. Short-term risk of periprocedural stroke relative to radial vs. femoral access: systematic review, meta-analysis, study sequential analysis and meta-regression of 2,188,047 real-world cardiac catheterizations. \textit{EXPERT REVIEW OF CARDIOVASCULAR THERAPY}. PHILADELPHIA: TAYLOR \&{} FRANCIS INC, 2023, roč.~21, č.~4, s.~293-304. ISSN~1477-9072. Dostupné z: https://dx.doi.org/10.1080/14779072.2023.2187378.
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