Radial Versus Femoral Access Is Associated With Reduced Complications and Mortality in Patients With Non–ST-Segment–Elevation Myocardial Infarction: An Observational Cohort Study of 10 095 Patients

Background—Compared with transfemoral access, transradial access (TRA) for percutaneous coronary intervention is associated with reduced risk of bleeding and vascular complications. Studies suggest that TRA may reduce mortality in patients with ST-segment–elevation myocardial infarction. However, there are few data on the effect of TRA on mortality, specifically, in patients with non–ST-segment–elevation myocardial infarction. Methods and Results—We analyzed 10 095 consecutive patients with non–ST-segment–elevation myocardial infarction treated with percutaneous coronary intervention between 2005 and 2011 in all 8 tertiary cardiac centers in London, United Kingdom. TRA was a predictor for reduced bleeding (odds ratio=0.21; 95% confidence interval [CI]: 0.08–0.57; P=0.002), access-site complications (odds ratio=0.47; 95% CI: 0.23–0.95; P=0.034), and 1-year mortality (hazard ratio [HR]=0.72; 95% CI: 0.54–0.94; P=0.017). Between 2005 and 2007, TRA did not appear to reduce mortality at 1 year (HR=0.81; 95% CI...