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

被引：58

作者：

Ando, Giuseppe ^{[1
]}

Cortese, Bernardo ^{[2
]}

Russo, Filippo ^{[3
]}

Rothenbhler, Martina ^{[4
,5
]}

Frigoli, Enrico ^{[6
]}

Gargiulo, Giuseppe ^{[7
,28
]}

Briguori, Carlo ^{[8
]}

Vranckx, Pascal ^{[9
]}

Leonardi, Sergio ^{[10
]}

Guiducci, Vincenzo ^{[11
]}

Belloni, Flavia ^{[12
]}

Ferrari, Fabio ^{[13
]}

Hernandez, Jose Maria de la Torre ^{[14
]}

Curello, Salvatore ^{[15
]}

Liistro, Francesco ^{[16
]}

Perkan, Andrea ^{[17
]}

De Servi, Stefano ^{[18
]}

Casu, Gavino ^{[19
]}

Dellavalle, Antonio ^{[20
]}

Fischetti, Dionigi ^{[21
]}

Micari, Antonio ^{[22
]}

Loi, Bruno ^{[23
]}

Mangiacapra, Fabio ^{[24
]}

Russo, Nunzio ^{[25
]}

Tarantino, Fabio ^{[26
]}

Saia, Francesco ^{[27
]}

Heg, Dik ^{[4
,5
]}

Windecker, Stephan ^{[28
]}

Juni, Peter ^{[28
,29
]}

Valgimigli, Marco ^{[28
]}

机构：

[1] Univ Messina, Azienda Osped Univ Policlin Gaetano Martino, Messina, Italy

[2] Osped Fate Bene Fratelli, Dept Med, Milan, Italy

[3] Azienda Osped St Anna, Como, Italy

[4] Univ Bern, CTU Bern, Bern, Switzerland

[5] Univ Bern, Inst Social & Prevent Med ISPM, Bern, Switzerland

[6] EUSTRATEGY Assoc, Forli, FC, Italy

[7] Univ Naples Federico II, Dept Adv Biomed Sci, Naples, Italy

[8] Clin Mediterranea, Naples, Italy

[9] Jessa Ziekenhuis, Hartctr Hasselt, Dept Cardiol & Crit Care Med, Hasselt, Belgium

[10] Fdn IRCCS Policlin San Matteo, Pavia, Italy

[11] AO Santa Maria Nuova, Reggio Emilia, Italy

[12] Osped Santo Spirito Saxia, Rome, Italy

[13] AO Univ San Luigi Gonzaga Orbassano Turin, Turin, Italy

[14] Hosp Marques de Valdecilla, Santander, Spain

[15] AO Spedali Civili, Brescia, Italy

[16] Osped San Donato, Arezzo, Italy

[17] ASUI, Trieste, Italy

[18] Osped Civile Legnano, Legnano, Italy

[19] Osped San Francesco, Nuoro, Italy

[20] Osped Riuniti ASL 17, Savigliano, CN, Italy

[21] Osped Vito Fazzi, Lecce, Italy

[22] GVM Care & Res Maria Eleonora Hosp, Palermo, Italy

[23] AO Brotzu, Cagliari, Italy

[24] Campus Biomed, Rome, Italy

[25] PO San Vincenzo, Taormina, ME, Italy

[26] Osped GB Morgagni, Forli, Italy

[27] Univ Hosp Bologna, Policlin S Orsola Malpighi, Bologna, Italy

[28] Bern Univ Hosp, Swiss Cardiovasc Ctr Bern, Freiburgstr 4, CH-3010 Bern, Switzerland

[29] Univ Bern, Inst Primary Hlth Care, Bern, Switzerland

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2017年 / 69卷 / 21期

关键词：

bleeding; coronary intervention; creatinine; estimated glomerular filtration rate; ST-segment elevation; CONTRAST-INDUCED NEPHROPATHY; CROSS BLUE-SHIELD; CARDIAC-CATHETERIZATION; VASCULAR ACCESS; RISK-FACTORS; INTERVENTIONS; INSIGHTS; IMPACT;

D O I：

10.1016/j.jacc.2017.02.070

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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) (J Am Coll Cardiol 2017; 69: 2592-603) (C) 2017 by the American College of Cardiology Foundation.

引用

页码：2592 / 2603

页数：12

共 28 条

[1] Impact of vascular access on acute kidney injury after percutaneous coronary intervention [J].

Ando, Giuseppe ;

Costa, Francesco ;

Trio, Olimpia ;

Oreto, Giuseppe ;

Valgimigli, Marco .

CARDIOVASCULAR REVASCULARIZATION MEDICINE, 2016, 17 (05) :333-338

[2] Acute kidney injury after percutaneous coronary intervention: Rationale of the AKI-MATRIX (acute kidney injury-minimizing adverse hemorrhagic events by TRansradial access site and systemic implementation of angioX) sub-study [J].

Ando, Giuseppe ;

Cortese, Bernardo ;

Frigoli, Enrico ;

Gagnor, Andrea ;

Garducci, Stefano ;

Briguori, Carlo ;

Rubartelli, Paolo ;

Calabro, Paolo ;

Valgimigli, Marco .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2015, 86 (05) :950-957

[3]

[Anonymous], KIDNEY INT SUPPL, DOI DOI 10.1038/kisup.2012.7

[4] Effects of withdrawing vs continuing renin-angiotensin blockers on incidence of acute kidney injury in patients with renal insufficiency undergoing cardiac catheterization: Results from the Angiotensin Converting Enzyme Inhibitor/Angiotensin Receptor Blocker and Contrast Induced Nephropathy in Patients Receiving Cardiac Catheterization (CAPTAIN) trial [J].

Bainey, Kevin R. ;

Rahim, Sherali ;

Etherington, Krystal ;

Rokoss, Michael L. ;

Natarajan, Madhu K. ;

Velianou, James L. ;

Brons, Sonya ;

Mehta, Shamir R. .

AMERICAN HEART JOURNAL, 2015, 170 (01) :110-116

[5] Comparison of Risk of Acute Kidney Injury After Primary Percutaneous Coronary Interventions With the Transradial Approach Versus the Transfemoral Approach (from the PRIPITENA Urban Registry) [J].

Cortese, Bernardo ;

Sciahbasi, Alessandro ;

Sebik, Rodrigo ;

Rigattieri, Stefano ;

Alonzo, Alessandro ;

Silva-Orrego, Pedro ;

Belloni, Flavia ;

Seregni, Romano G. ;

Giovannelli, Francesca ;

Tespili, Maurizio ;

Ricci, Roberto ;

Berni, Andrea .

AMERICAN JOURNAL OF CARDIOLOGY, 2014, 114 (06) :820-825

[6] The incidence of acute kidney injury after cardiac catheterization or PCI: A comparison of radial vs. femoral approach [J].

Damluji, Abdulla ;

Cohen, Mauricio G. ;

Smairat, Ramez ;

Steckbeck, Robert ;

Moscucci, Mauro ;

Gilchrist, Ian C. .

INTERNATIONAL JOURNAL OF CARDIOLOGY, 2014, 173 (03) :595-597

[7] The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: A prospective study [J].

Fukumoto, Y ;

Tsutsui, H ;

Tsuchihashi, M ;

Masumoto, A ;

Takeshita, A .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 42 (02) :211-216

[8] Meta-Analysis of Randomized Controlled Trials of Preprocedural Stain Administration for Reducing Contrast-Induced Acute Kidney Injury in patients Undergoing Coronary Catheterization [J].

Giacoppo, Daniele ;

Capodanno, Davide ;

Capranzano, Piera ;

Aruta, Patrizia ;

Tamburino, Corrado .

AMERICAN JOURNAL OF CARDIOLOGY, 2014, 114 (04) :541-548

[9] Renal Function-Based Contrast Dosing to Define Safe Limits of Radiographic Contrast Media in Patients Undergoing Percutaneous Coronary Interventions [J].

Gurm, Hitinder S. ;

Dixon, Simon R. ;

Smith, Dean E. ;

Share, David ;

LaLonde, Thomas ;

Greenbaum, Adam ;

Moscucci, Mauro .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 58 (09) :907-914

[10]

Karkouti K, 2015, CAN J ANESTH, V62, P377, DOI 10.1007/s12630-014-0302-y

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