Distal radial access in acute coronary syndrome patients with good arterial pulsation: a subgroup analysis from the KODRA registry.
JW, L., SY, K., JH, H., HY, J., SW, C., Y, K., BK, L., SY, Y., SY, L., & CJ, K. (2026). Distal radial access in acute coronary syndrome patients with good arterial pulsation: a subgroup analysis from the KODRA registry.. The Korean journal of internal medicine. https://doi.org/10.3904/kjim.2025.349
JW L, SY K, JH H, HY J, SW C, Y K, et al. Distal radial access in acute coronary syndrome patients with good arterial pulsation: a subgroup analysis from the KODRA registry.. The Korean journal of internal medicine. 2026; doi: 10.3904/kjim.2025.349
JW L, SY K, JH H, et al. Distal radial access in acute coronary syndrome patients with good arterial pulsation: a subgroup analysis from the KODRA registry.[J]. The Korean journal of internal medicine. 2026. DOI: 10.3904/kjim.2025.349.
@article{jw2026,
author = {Lee JW and Kim SY and Heo JH and Jin HY and Cho SW and Kim Y and Lee BK and Yoo SY and Lee SY and Kim CJ},
title = {Distal radial access in acute coronary syndrome patients with good arterial pulsation: a subgroup analysis from the KODRA registry.},
journal = {The Korean journal of internal medicine},
year = {2026},
doi = {10.3904/kjim.2025.349},
note = {PMID: 42438907},
}
TY - JOUR AU - Lee JW AU - Kim SY AU - Heo JH AU - Jin HY AU - Cho SW AU - Kim Y AU - Lee BK AU - Yoo SY AU - Lee SY AU - Kim CJ TI - Distal radial access in acute coronary syndrome patients with good arterial pulsation: a subgroup analysis from the KODRA registry. T2 - The Korean journal of internal medicine PY - 2026 DO - 10.3904/kjim.2025.349 AN - PMID:42438907 ER -
BACKGROUND/AIMS: Distal radial access (DRA) has been associated with fewer access-site complications, but evidence in acute coronary syndrome (ACS) remains limited. This study evaluated the feasibility and safety of DRA in ACS patients with good arterial pulsation. METHODS: Patients with good arterial pulsation from the prospective, multicenter KODRA registry were analyzed, comparing those with ACS (n = 1,618) and non-ACS (n = 2,588). The primary efficacy endpoint was successful coronary angiography (CAG) without access-site crossover. The primary safety endpoint was DRA-related bleeding, and the secondary safety endpoint was radial artery occlusion (RAO). Multivariable logistic regression was performed to assess the association between ACS and study endpoints. RESULTS: The mean age was 66.3 ± 11.9 years, and 69.6% were male. The rate of successful CAG without access-site crossover was comparable between ACS and non-ACS patients (94.2% vs. 94.9%, p = 0.094). DRA-related bleeding occurred more frequently in ACS (4.3% vs. 2.6%, p = 0.002). RAO rates were similar before discharge (0.1% vs. 0.2%, p = 0.396), but lower at one-month in ACS patients (0.3% vs. 1.0%, p = 0.010). ACS was not independently associated with either primary efficacy (OR 0.871, 95% CI 0.664-1.144) or primary safety endpoint (OR 0.817, 95% CI 0.538-1.240). CONCLUSION: In patients with good arterial pulsation, DRA was feasible in ACS, with higher bleeding but lower RAO compared with non-ACS. ACS was not independently associated with procedural failure or DRA-related bleeding. DRA may be considered a reasonable access strategy in selected ACS patients.