Distal Radial Access vs Transradial Access in Patients With ST-Segment Elevation Myocardial Infarction: The DRAMI Trial
Authors' conclusion
In STEMI patients, DRA failed to demonstrate noninferiority to TRA in terms of puncture success. However, both access routes showed comparable procedural efficacy and safety.
Study context
- Population
- Patients undergoing primary percutaneous coronary intervention (PCI) for STEMI
- Participants
- 354 patients
- Comparison
- Distal radial access vs transradial access
- Distal radial access (DRA)n = 176
- Transradial access (TRA)n = 178reference
- Primary endpoint
- Puncture success rate
Methodological detailsmulticentre, open-label, non-inferiority, 3 centres in South Korea, Enrolment August 2018 to February 2023
- Multicentre
- Open-label
- Non-inferiority
- 3 centres in South Korea
- Enrolment August 2018 to February 2023
Primary result
As reported in the abstract
DRA vs TRADifference (95% CI)
Intention-to-treat; noninferiority not demonstrated
−1.75%(−6.20% to 2.71%)
Per-protocol; failed to demonstrate noninferiority
−1.72%(−5.99% to 2.54%)
As-treated; noninferiority demonstrated
−1.17%(−5.56% to 3.22%)
Non-inferiority margin 5.65 as printed, not drawn
Further findings
Successful coronary angiography and PCI, access-site crossover
- Comparable between groups
Safety
- Radial artery occlusion · 1-month follow-up — TRA
- 1 events
Bleeding complications
- Comparable between groups
Original publication
Distal Radial Access vs Transradial Access in Patients With ST-Segment Elevation Myocardial Infarction: The DRAMI Trial. JACC Adv. Published 29 September 2025. doi:10.
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