Validation of a Predictive Score for Radial Artery Spasm in Patients Undergoing Elective Transradial Percutaneous Coronary Procedures.

BACKGROUND: Radial artery spasm (RAS) is one of the most common complications during transradial coronary procedures and can increase access-site-related adverse events. There is no standard tool to determine patients at high risk of RAS who would benefit from intensive spasmpreventive measures. This study aims to validate a RAS risk score in patients undergoing elective transradial coronary procedures.

METHODOLOGY: The study population consisted of a prospective cohort of patients who underwent elective transradial coronary angiography and PCI (n=210). A RAS risk score was used to classify patients as high or low risk. Spasm incidence was recorded and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the RAS risk score were determined.

RESULTS: RAS incidence was 11.43%. A greater number of patients who had RAS were females (p=0.023), weighed less (64.4 ± 9.20 kg, p=0.0353), had lower body mass index (BMI) (19.9 ± 2.33, p=0.0512), were current smokers (p=0.031) and had peripheral artery disease (PAD) (p<001). The RAS risk score had a sensitivity of 87.50%, a specificity of 76.34%, PPV of 32.31%, NPV of 97.93% and accuracy of 77.62% with c-statistic of 0.8685.

CONCLUSION: The RAS risk score may be a good tool to identify patients at high risk of RAS during elective transradial coronary procedures in whom more intensive spasm-preventive measures can possibly lead to a significant reduction in the frequency of RAS and potentially reduce access-site-related adverse events.

KEYWORDS: Radial artery spasm, radial artery spasm risk score, predictor of radial artery spasm