| Background:Transradial percutaneous coronary intervention (TRI) is associated with fewer complications, shorter length of stay and better patient satisfaction than transfemoral approach. While there are few studies examining the cost-effectiveness of transradial vs. transfemoral (TFI) in the United States, the majority of transradial PCI were performed in few centers among highly selective patientts. Importantly, cost data obtained from the United States and European countries might not be generalizable to the developing world. There is limited data comparing hospital cost of TRI and TFI in China.Methods:We conducted a retrospective study from the Fuwai PCI database, a single center registry from the largest heart center in China between January and December2010. Using propensity score inverseprobability weighting (IPW) approach, we compared total hospital costs and inpatient outcomes between TRI and TFI.Results:Of5478patients receiving percutaneous corornary intervention (PCI),4837(88.3%) were with TRI procedures. Complications in the TRI group related to arteriopunctureare were less than those in the TFI group(OR=0.27,95%CI:0.17-0.44, p<0.001).The difference was also statistically significant after adjustment with IPW (OR=0.23,95%CI:0.14-0.35, p<0.001). The total incidence of major adverse cardiovascular event (MACE)of in-hospital death, myocardial infarction and revascularization were not statistically significant different between TRI and TFI group (1.1%vs.1.7%; OR=0.67,95%CI:0.34-1.29, p=0.230). Length of stay was significantly shorter in the TRI group after adjusting with IPW (6.3days vs.7.8days, difference=-1.5days,95%CI:-1.9days to-1.2days, p<0.0001). Total unadjusted cost was lower in the TRI group. After adjustment with IPW, the costs in the TRI group were statistically significantly lower than those in the TFI group (￥58765.5vs. Y67007.0difference=￥-8241.4,95%CI:Y-10344.0to￥-6138.9, p<0.0001). The PCI procedure-related costs in the TRI group was also lower than those in the TFI group.(Y44367.2vs.￥49261.7, difference=￥-4894.5,95%CI:￥-6674.4to￥-3114.6, p<0.0001). Conclusions:Compared with the TFI approach, TRI was associated with lower incidence of bleeding complications, shorter length of stay and lower hospital costs. Objective:To analyze the characteristics of coronary angiography of coronary artery disease (CAD) in patients with complete right bundle branch block (RBBB).Methods:189patients with electrocardiographic findings of RBBB were subjected to coronary angiographic study. The age ranged from38to86years old (mean61.3±10.3years). There were154male and35female patients. The diagnosis of RBBB was based upon electrocardiography. Patients underwent selective coronary angiography and right ventriculography by use of the Judkins technique. Statistical analysis was performed using SAS software.Results:Of the189patients,71%had CAD. Compared with the patients without CAD, the patients with CAD were older; more likely to be male; more likely to have previous myocardial infarction, diabetes mellitus and hypertension. Coronary angiogram revealed that single vessel disease; double vessels disease and triple vessels disease were35.1%,24.6%and40.3%respectively. Left anterior descending lesion was most. Independent predictors for CAD with RBBB are male gender, advanced age, diabetes mellitus and hypertension.Conclusions:Most of the subjects with RBBB and concomitant CAD are likely to have certain clinical characteristics, the patients with CAD were older; more likely to be men; more likely to have previous myocardial infarction, diabetes mellitus and hypertension. When RBBB was associated with chest pain of uncertain etiology, or unexplained electrocardiographic abnormality, coronary angiogram was helpful to confirm ischemic heart disease and etiology.
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