Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management: AKI-MATRIX

Giuseppe Andò, Bernardo Cortese, Filippo Russo, Martina Rothenbühler, Enrico Frigoli, Giuseppe Gargiulo, Carlo Briguori, Pascal Vranckx, Sergio Leonardi, Vincenzo Guiducci, Flavia Belloni, Fabio Ferrari, Jose Maria de la Torre Hernandez, Salvatore Curello, Francesco Liistro, Andrea Perkan, Stefano De Servi, Gavino Casu, Antonio Dellavalle, Dionigi FischettiAntonio Micari, Bruno Loi, Fabio Mangiacapra, Nunzio Russo, Fabio Tarantino, Francesco Saia, Dik Heg, Stephan Windecker, Peter Jüni, Marco Valgimigli, Maria Salomone, Monica Portolan, Francesco Costa, Sergio Leonardi, Andrea Santarelli, Ezio Bramucci, Patrizia Presbitero, Carlo Vigna, Giovanni Esposito, Patrizia Presbitero, Dennis Zavalloni-Parenti, Andrea Santarelli, Giovanni Esposito, Carlo Vigna, Antonio Colombo, Alaide Chieffo, Stefano De Servi, Marcello Caputo, Maurizio Ferrario, Ezio Bramucci, MATRIX Investigators, MATRIX Investigators

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Background It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). Objectives The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. Methods Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis. The primary AKI-MATRIX endpoint was AKI, defined as an absolute (>0.5 mg/dl) or a relative (>25%) increase in serum creatinine (sCr). Results AKI occurred in 634 patients (15.4%) with RA and 712 patients (17.4%) with FA (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.77 to 0.98; p = 0.0181). A >25% sCr increase was noted in 633 patients (15.4%) with RA and 710 patients (17.3%) with FA (OR: 0.87; 95% CI: 0.77 to 0.98; p = 0.0195), whereas a >0.5 mg/dl absolute sCr increase occurred in 175 patients (4.3%) with RA versus 223 patients (5.4%) with FA (OR: 0.77; 95% CI: 0.63 to 0.95; p = 0.0131). By implementing the Kidney Disease Improving Global Outcomes criteria, AKI was 3-fold less prevalent and trended lower with RA (OR: 0.85; 95% CI: 0.70 to 1.03; p = 0.090), with stage 3 AKI occurring in 28 patients (0.68%) with RA versus 46 patients (1.12%) with FA (p = 0.0367). Post-intervention dialysis was needed in 6 patients (0.15%) with RA and 14 patients (0.34%) with FA (p = 0.0814). Stratified analyses suggested greater benefit with RA than FA in patients at greater risk for AKI. Conclusions In ACS patients who underwent invasive management, RA was associated with a reduced risk of AKI compared with FA. (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX [MATRIX]; NCT01433627)

Original languageEnglish
Pages (from-to)2592-2603
Number of pages12
JournalJournal of the American College of Cardiology
Volume69
Issue number21
DOIs
Publication statusPublished - May 30 2017

Fingerprint

Acute Coronary Syndrome
Thigh
Acute Kidney Injury
Creatinine
Odds Ratio
Confidence Intervals
Dialysis
Serum
Kidney Diseases
Angiography

Keywords

  • bleeding
  • coronary intervention
  • creatinine
  • estimated glomerular filtration rate
  • ST-segment elevation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Andò, G., Cortese, B., Russo, F., Rothenbühler, M., Frigoli, E., Gargiulo, G., ... MATRIX Investigators (2017). Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management: AKI-MATRIX. Journal of the American College of Cardiology, 69(21), 2592-2603. https://doi.org/10.1016/j.jacc.2017.02.070

Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management : AKI-MATRIX. / Andò, Giuseppe; Cortese, Bernardo; Russo, Filippo; Rothenbühler, Martina; Frigoli, Enrico; Gargiulo, Giuseppe; Briguori, Carlo; Vranckx, Pascal; Leonardi, Sergio; Guiducci, Vincenzo; Belloni, Flavia; Ferrari, Fabio; de la Torre Hernandez, Jose Maria; Curello, Salvatore; Liistro, Francesco; Perkan, Andrea; De Servi, Stefano; Casu, Gavino; Dellavalle, Antonio; Fischetti, Dionigi; Micari, Antonio; Loi, Bruno; Mangiacapra, Fabio; Russo, Nunzio; Tarantino, Fabio; Saia, Francesco; Heg, Dik; Windecker, Stephan; Jüni, Peter; Valgimigli, Marco; Salomone, Maria; Portolan, Monica; Costa, Francesco; Leonardi, Sergio; Santarelli, Andrea; Bramucci, Ezio; Presbitero, Patrizia; Vigna, Carlo; Esposito, Giovanni; Presbitero, Patrizia; Zavalloni-Parenti, Dennis; Santarelli, Andrea; Esposito, Giovanni; Vigna, Carlo; Colombo, Antonio; Chieffo, Alaide; De Servi, Stefano; Caputo, Marcello; Ferrario, Maurizio; Bramucci, Ezio; MATRIX Investigators; MATRIX Investigators.

In: Journal of the American College of Cardiology, Vol. 69, No. 21, 30.05.2017, p. 2592-2603.

Research output: Contribution to journalArticle

Andò, G, Cortese, B, Russo, F, Rothenbühler, M, Frigoli, E, Gargiulo, G, Briguori, C, Vranckx, P, Leonardi, S, Guiducci, V, Belloni, F, Ferrari, F, de la Torre Hernandez, JM, Curello, S, Liistro, F, Perkan, A, De Servi, S, Casu, G, Dellavalle, A, Fischetti, D, Micari, A, Loi, B, Mangiacapra, F, Russo, N, Tarantino, F, Saia, F, Heg, D, Windecker, S, Jüni, P, Valgimigli, M, Salomone, M, Portolan, M, Costa, F, Leonardi, S, Santarelli, A, Bramucci, E, Presbitero, P, Vigna, C, Esposito, G, Presbitero, P, Zavalloni-Parenti, D, Santarelli, A, Esposito, G, Vigna, C, Colombo, A, Chieffo, A, De Servi, S, Caputo, M, Ferrario, M, Bramucci, E, MATRIX Investigators & MATRIX Investigators 2017, 'Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management: AKI-MATRIX', Journal of the American College of Cardiology, vol. 69, no. 21, pp. 2592-2603. https://doi.org/10.1016/j.jacc.2017.02.070
Andò, Giuseppe ; Cortese, Bernardo ; Russo, Filippo ; Rothenbühler, Martina ; Frigoli, Enrico ; Gargiulo, Giuseppe ; Briguori, Carlo ; Vranckx, Pascal ; Leonardi, Sergio ; Guiducci, Vincenzo ; Belloni, Flavia ; Ferrari, Fabio ; de la Torre Hernandez, Jose Maria ; Curello, Salvatore ; Liistro, Francesco ; Perkan, Andrea ; De Servi, Stefano ; Casu, Gavino ; Dellavalle, Antonio ; Fischetti, Dionigi ; Micari, Antonio ; Loi, Bruno ; Mangiacapra, Fabio ; Russo, Nunzio ; Tarantino, Fabio ; Saia, Francesco ; Heg, Dik ; Windecker, Stephan ; Jüni, Peter ; Valgimigli, Marco ; Salomone, Maria ; Portolan, Monica ; Costa, Francesco ; Leonardi, Sergio ; Santarelli, Andrea ; Bramucci, Ezio ; Presbitero, Patrizia ; Vigna, Carlo ; Esposito, Giovanni ; Presbitero, Patrizia ; Zavalloni-Parenti, Dennis ; Santarelli, Andrea ; Esposito, Giovanni ; Vigna, Carlo ; Colombo, Antonio ; Chieffo, Alaide ; De Servi, Stefano ; Caputo, Marcello ; Ferrario, Maurizio ; Bramucci, Ezio ; MATRIX Investigators ; MATRIX Investigators. / Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management : AKI-MATRIX. In: Journal of the American College of Cardiology. 2017 ; Vol. 69, No. 21. pp. 2592-2603.
@article{b168477a22ec417caa1dbf9ee08ae18b,
title = "Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management: AKI-MATRIX",
abstract = "Background It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). Objectives The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. Methods Among 8,404 patients, 194 (2.3{\%}) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis. The primary AKI-MATRIX endpoint was AKI, defined as an absolute (>0.5 mg/dl) or a relative (>25{\%}) increase in serum creatinine (sCr). Results AKI occurred in 634 patients (15.4{\%}) with RA and 712 patients (17.4{\%}) with FA (odds ratio [OR]: 0.87; 95{\%} confidence interval [CI]: 0.77 to 0.98; p = 0.0181). A >25{\%} sCr increase was noted in 633 patients (15.4{\%}) with RA and 710 patients (17.3{\%}) with FA (OR: 0.87; 95{\%} CI: 0.77 to 0.98; p = 0.0195), whereas a >0.5 mg/dl absolute sCr increase occurred in 175 patients (4.3{\%}) with RA versus 223 patients (5.4{\%}) with FA (OR: 0.77; 95{\%} CI: 0.63 to 0.95; p = 0.0131). By implementing the Kidney Disease Improving Global Outcomes criteria, AKI was 3-fold less prevalent and trended lower with RA (OR: 0.85; 95{\%} CI: 0.70 to 1.03; p = 0.090), with stage 3 AKI occurring in 28 patients (0.68{\%}) with RA versus 46 patients (1.12{\%}) with FA (p = 0.0367). Post-intervention dialysis was needed in 6 patients (0.15{\%}) with RA and 14 patients (0.34{\%}) with FA (p = 0.0814). Stratified analyses suggested greater benefit with RA than FA in patients at greater risk for AKI. Conclusions In ACS patients who underwent invasive management, RA was associated with a reduced risk of AKI compared with FA. (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX [MATRIX]; NCT01433627)",
keywords = "bleeding, coronary intervention, creatinine, estimated glomerular filtration rate, ST-segment elevation",
author = "Giuseppe And{\`o} and Bernardo Cortese and Filippo Russo and Martina Rothenb{\"u}hler and Enrico Frigoli and Giuseppe Gargiulo and Carlo Briguori and Pascal Vranckx and Sergio Leonardi and Vincenzo Guiducci and Flavia Belloni and Fabio Ferrari and {de la Torre Hernandez}, {Jose Maria} and Salvatore Curello and Francesco Liistro and Andrea Perkan and {De Servi}, Stefano and Gavino Casu and Antonio Dellavalle and Dionigi Fischetti and Antonio Micari and Bruno Loi and Fabio Mangiacapra and Nunzio Russo and Fabio Tarantino and Francesco Saia and Dik Heg and Stephan Windecker and Peter J{\"u}ni and Marco Valgimigli and Maria Salomone and Monica Portolan and Francesco Costa and Sergio Leonardi and Andrea Santarelli and Ezio Bramucci and Patrizia Presbitero and Carlo Vigna and Giovanni Esposito and Patrizia Presbitero and Dennis Zavalloni-Parenti and Andrea Santarelli and Giovanni Esposito and Carlo Vigna and Antonio Colombo and Alaide Chieffo and {De Servi}, Stefano and Marcello Caputo and Maurizio Ferrario and Ezio Bramucci and {MATRIX Investigators} and {MATRIX Investigators}",
year = "2017",
month = "5",
day = "30",
doi = "10.1016/j.jacc.2017.02.070",
language = "English",
volume = "69",
pages = "2592--2603",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "21",

}

TY - JOUR

T1 - Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management

T2 - AKI-MATRIX

AU - Andò, Giuseppe

AU - Cortese, Bernardo

AU - Russo, Filippo

AU - Rothenbühler, Martina

AU - Frigoli, Enrico

AU - Gargiulo, Giuseppe

AU - Briguori, Carlo

AU - Vranckx, Pascal

AU - Leonardi, Sergio

AU - Guiducci, Vincenzo

AU - Belloni, Flavia

AU - Ferrari, Fabio

AU - de la Torre Hernandez, Jose Maria

AU - Curello, Salvatore

AU - Liistro, Francesco

AU - Perkan, Andrea

AU - De Servi, Stefano

AU - Casu, Gavino

AU - Dellavalle, Antonio

AU - Fischetti, Dionigi

AU - Micari, Antonio

AU - Loi, Bruno

AU - Mangiacapra, Fabio

AU - Russo, Nunzio

AU - Tarantino, Fabio

AU - Saia, Francesco

AU - Heg, Dik

AU - Windecker, Stephan

AU - Jüni, Peter

AU - Valgimigli, Marco

AU - Salomone, Maria

AU - Portolan, Monica

AU - Costa, Francesco

AU - Leonardi, Sergio

AU - Santarelli, Andrea

AU - Bramucci, Ezio

AU - Presbitero, Patrizia

AU - Vigna, Carlo

AU - Esposito, Giovanni

AU - Presbitero, Patrizia

AU - Zavalloni-Parenti, Dennis

AU - Santarelli, Andrea

AU - Esposito, Giovanni

AU - Vigna, Carlo

AU - Colombo, Antonio

AU - Chieffo, Alaide

AU - De Servi, Stefano

AU - Caputo, Marcello

AU - Ferrario, Maurizio

AU - Bramucci, Ezio

AU - MATRIX Investigators

AU - MATRIX Investigators

PY - 2017/5/30

Y1 - 2017/5/30

N2 - Background It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). Objectives The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. Methods Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis. The primary AKI-MATRIX endpoint was AKI, defined as an absolute (>0.5 mg/dl) or a relative (>25%) increase in serum creatinine (sCr). Results AKI occurred in 634 patients (15.4%) with RA and 712 patients (17.4%) with FA (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.77 to 0.98; p = 0.0181). A >25% sCr increase was noted in 633 patients (15.4%) with RA and 710 patients (17.3%) with FA (OR: 0.87; 95% CI: 0.77 to 0.98; p = 0.0195), whereas a >0.5 mg/dl absolute sCr increase occurred in 175 patients (4.3%) with RA versus 223 patients (5.4%) with FA (OR: 0.77; 95% CI: 0.63 to 0.95; p = 0.0131). By implementing the Kidney Disease Improving Global Outcomes criteria, AKI was 3-fold less prevalent and trended lower with RA (OR: 0.85; 95% CI: 0.70 to 1.03; p = 0.090), with stage 3 AKI occurring in 28 patients (0.68%) with RA versus 46 patients (1.12%) with FA (p = 0.0367). Post-intervention dialysis was needed in 6 patients (0.15%) with RA and 14 patients (0.34%) with FA (p = 0.0814). Stratified analyses suggested greater benefit with RA than FA in patients at greater risk for AKI. Conclusions In ACS patients who underwent invasive management, RA was associated with a reduced risk of AKI compared with FA. (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX [MATRIX]; NCT01433627)

AB - Background It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). Objectives The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. Methods Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis. The primary AKI-MATRIX endpoint was AKI, defined as an absolute (>0.5 mg/dl) or a relative (>25%) increase in serum creatinine (sCr). Results AKI occurred in 634 patients (15.4%) with RA and 712 patients (17.4%) with FA (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.77 to 0.98; p = 0.0181). A >25% sCr increase was noted in 633 patients (15.4%) with RA and 710 patients (17.3%) with FA (OR: 0.87; 95% CI: 0.77 to 0.98; p = 0.0195), whereas a >0.5 mg/dl absolute sCr increase occurred in 175 patients (4.3%) with RA versus 223 patients (5.4%) with FA (OR: 0.77; 95% CI: 0.63 to 0.95; p = 0.0131). By implementing the Kidney Disease Improving Global Outcomes criteria, AKI was 3-fold less prevalent and trended lower with RA (OR: 0.85; 95% CI: 0.70 to 1.03; p = 0.090), with stage 3 AKI occurring in 28 patients (0.68%) with RA versus 46 patients (1.12%) with FA (p = 0.0367). Post-intervention dialysis was needed in 6 patients (0.15%) with RA and 14 patients (0.34%) with FA (p = 0.0814). Stratified analyses suggested greater benefit with RA than FA in patients at greater risk for AKI. Conclusions In ACS patients who underwent invasive management, RA was associated with a reduced risk of AKI compared with FA. (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX [MATRIX]; NCT01433627)

KW - bleeding

KW - coronary intervention

KW - creatinine

KW - estimated glomerular filtration rate

KW - ST-segment elevation

UR - http://www.scopus.com/inward/record.url?scp=85019392476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019392476&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2017.02.070

DO - 10.1016/j.jacc.2017.02.070

M3 - Article

AN - SCOPUS:85019392476

VL - 69

SP - 2592

EP - 2603

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 21

ER -