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Whether the use of routine transradial intervention improves outcomes in widely unselected patients with acute coronary syndrome (ACS) has been uncertain. In a large, multicenter, randomized, industry-funded trial, 8404 ACS patients were randomly assigned radial or femoral access for coronary angiography and, if needed, percutaneous coronary intervention. Coprimary outcomes were major adverse cardiovascular events and net adverse clinical events.
At 30 days, rates of the first coprimary outcome were lower with radial access (8.8%) compared with femoral access (10.3%; rate ratio, 0.85; 95% confidence interval, 0.74–0.99; P=0.0307, formally nonsignificant at a two-sided α of 0.025). The second coprimary outcome occurred in significantly fewer …