Objectives To evaluate the efficacy and complications of transradial approach and transfemoral approach in the treatment of acute myocardial infarction with primary percutaneous coronary intervention (PCI) with power antithrombotic therapy and to explore whether transradial approach could be the first approach.

Methods A prospective study was conducted with the data of 89 patients (group A) with acute myocardial infarction (AMI) who underwent transradial primary PCI, 83 patients (group B) underwent transfemoral primary PCI compressing to stop bleeding by hand and 87 patients (group C) underwent transfemoral primary PCI compressing to stop bleeding by stapler. The incidence of major adverse cardiovascular events (MACE), including death, myocardial infarction, target lesion revascularisation found in 90 days, were compared among the three groups, the rates of stent thrombosis and restenosis were also compared. The complications were compared among the three groups.

Results No significant differences in baseline characteristics were observed among the three groups. PCI was successfully accomplished in all patients. After 3 month follow-up, no significant difference was found in the MACE rate among the three groups (P > 0.05). The complications in group A were more less compared with that of group B and C (P < 0.001) and there was no difference between B and C (P > 0.05).

Conclusions The transradial approach primary PCI in the treatment of acute myocardial infarction has a similar efficiency in group A with that of group B and C. The complications were much less in group A than that of group B and C. The transradial approach primary PCI in the treatment of acute myocardial infarction should be the first selection of approach.