The protective role of low-dose acetylsalicylic acid use and relation with inflammatory and thrombotic parameters on radial artery occlusion in patients undergoing elective transradial coronary angiography

Abstract

Aim: Transradial angiography (TRA) is recommended in clinical practice; it is better than the transfemoral route to prevent site-related complications. Radial artery occlusion is one of the most seen significant complications after TRA. In the present study, the protective effect of low dose acetylsalicylic acid (ASA) use against the radial artery occlusion (RAO) and the predictive ability of some thrombotic and inflammatory factors for the development of RAO were investigated. Material and Method: One thousand two hundred fifty-four patients who planned for elective coronary angiography were screened to include transradial coronary angiography. The patients have grouped group I, who took ASA (100 mg) (n= 56), and group II (n= 51), who did not. Blood samples were taken immediately after sheath insertion and after the six hours of the sheath removal. The D-dimer and C-reactive protein values were analyzed between groups. In the first 24 hours after the procedure, the radial Doppler ultrasonography assessment was performed to detect RAO. Multivariable regression analysis was used to evaluate the independent risk factors for the TRA. Results: Eligible one hundred seven stable patients were included in the study. The demographic, laboratory and procedural characteristics were similar between the two groups (Table 2). TRA was statistically lower in Group I compared to Group II. (n=3 vs. n=22, p=.001). Multivariable regression analysis demonstrated that postprocedural higher D-dimer levels and non-ASA status were found to be the independent risk factors for RAO (OR (95% CI=1.235(1.014-1.582) p=.001, 5.534 (3.376-9.252), p <.001). ROC analysis demonstrated the cut-off value of the D-dimer level was 144 ng/ml for predicting RAO (AUC =0.658, sensitivity 62.4%, specificity 89.2%, p=.016). Preprocedural and postprocedural CRP values did not differ between groups (p>.05). Conclusion: Preprocedural ASA use may have a protective role against the RAO. Pre- and post-procedural D-dimer levels can predict the thrombotic process in the early phase of the RAO.

Keywords

• Acetylsalicylic acid
• radial artery occlusion
• D-dimer
• C-reactive protein
• protection

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