IJCS | Volume 31, Nº6, November / December 2018

564 Figure 01 - Box-plot comparing the CRUSADE score (Graph A) with the ACUITY score (Graph B) values between radial access and femoral access groups. Graph A Graph B CRUSADE score ACUITY score Femoral Radial Femoral Radial Lacerda et al. Paradoxical choice for radial access in ACS Int J Cardiovasc Sci. 2018;31(6)562-568 Original Article were described as absolute and relative frequencies. The CRUDADE and ACUITY scores were compared between radial and femoral groups by the unpaired Student’s t test. Predictors of the radial access were compared between both groups by the chi-square test or the unpaired Student’s t test. Variables with p < 0.10 in the univariate analysis were inserted into the logistic regression, with radial access as dependent variable; the odds ratio of each predictor was determined. A p < 0.05 was set as statistically significant in all tests. The analysis was performed using the SPSS software version 21. Results Sample description A total of 347 patients were included; mean age was 63 ± 14 years, 63%were men, 27%of themwere hospitalized for ST-segment elevation myocardial infarction (the others had ASC with non-ST-segment elevation myocardial infarction). Invasive coronary angiography showed that 38% of patients had three-vessel disease or left coronary artery occlusion. Mean GRACE score was 119 ± 37, compatible with an intermediate risk of cardiovascular events. Mean CRUSADE score was 32 ± 15 andmean ACUITY score was 14 ± 7, both corresponding to moderate risk of bleeding according to validation studies. 8,9 Bleeding occurred in 64 patients (18%) and major bleeding in 12 (3.5%). The CRUSADE score was higher in patients with major bleeding (47 ± 17 versus 32 ± 15; p = 0.01), confirming its predictive value. The same was observed with the ACUITY score (20 ± 9 versus 14 ± 7; p = 0.02). Patients treated with the radial approach showed a higher incidence of major bleeding as compared with those treated with femoral access (1% versus 8%; p < 0.01). Risk of bleeding and the choice for the radial access The radial artery was chosen as the primary vascular access in 64% of patients, whereas the femoral access was chosen for the others. Themean CRUSADE score showed that patients treated with the radial access showed a lower risk of bleeding (30 ± 14) compared with those treated with femoral access (37 ± 15; p < 0.001) (Figure 1). According to the literature, these values corresponded to a bleeding risk of 5.5% and 8.6%, respectively. 8 Analysis of the ACUITY score corroborated the fact that patients treated with radial access had a higher risk of bleeding than patients treated with femoral access (13 ± 6 versus 15 ± 7; p = 0.002). These values correspond to a bleeding risk of 3.3% and 6.9%, respectively. 9 Propensity to choose the radial access With respect to general characteristics of patients, those with a radial access were younger (61 ± 13 years), compared with patients with femoral access (66 ± 14 years; p < 0.001). Sex, self-reported race, weight, height,