Acute kidney injury after radial or femoral artery access in ST-segment elevation myocardial infarction: AKI-SAFARI

Marbach, Jeffrey A.; Wells, George; Santo, Pietro Di; So, Derek; Chong, Aun‐Yeong; Russo, Juan; Labinaz, Marino; Dick, Alexander; Froeschl, Michael; Glover, Christopher; Hibbert, Benjamin; Marquis, Jean-François; MacDougall, Arlene; Kass, Malek; Paddock, V.; Quraishi, Ata ur Rehman; Chandrasekhar, Jaya; Ghosh, Nina; Bernick, Jordan; May, Michel Le

doi:10.1016/j.ahj.2020.12.019

Cited by 11 publications

(14 citation statements)

References 37 publications

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“…e overall methodological quality of the studies included was generally good, as measured by the Cochrane collaboration tool for RCT and NOS for retrospective studies (Supplementary Table 1; Supplementary Figure 1). A total of 5 multicenter studies (2 RCTs and 3 PSM studies) from 2014 to 2021 with a total of 8,536 STEMI patients were included [16][17][18][19][20]. Distribution of total TRA and TFA patient was almost even (4265 and 4271 for TRA and TFA, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…To elucidate the risk difference between the access sites with AKI in patients with STEMI, studies have been performed in selected populations [16][17][18][19][20]. Kooiman et al demonstrated a reduced incidence of AKI in patients with TRA access over TFA access.…”

Section: Discussionmentioning

confidence: 99%

“…Cholesterol crystals embolize into the renal arteries during catheter manipulation in the aorta, and due to less contact of catheters to the aortic wall, it may be less common in PCI undergone by TRA [ 24 ]. Bleeding and transfusions are more common in TFA [ 22 ]; furthermore, current data suggest that significant periprocedural bleeding events, particularly the need for blood transfusion, may be the most important determinants of AKI following primary PCI in STEMI patients [ 18 ]. Therefore, in cases where access site contributes to bleeding events, there is a potential for an increased AKI incidence.…”

Section: Discussionmentioning

confidence: 99%

“…The limitations of this study were as follows: follow-up was limited to hospital stay and there was no exact information of how many patients were treated with N-acetylcysteine or bicarbonate infusion for AKI. The AKI-SAFARI [ 18 ] and the STEMI subgroup in the AKI-MATRIX [ 19 ] trials demonstrated no association between catheterization access site and AKI, irrespective of the AKI definition applied. It should also be noted that the insignificant differences in bleeding and transfusion requirements made between the two groups (TFA and TRA) were what lead to the nonstatistical difference in AKI.…”

Section: Discussionmentioning

confidence: 99%

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Transradial versus Transfemoral Access and the Risk of Acute Kidney Injury following Primary Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies

Rio‐Pertuz

Juarez²,

Mekraksakit

et al. 2022

Journal of Interventional Cardiology

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Objectives. The aim of this study is to examine the association between vascular access sites and the incidence of AKI in patients with STEMI undergoing primary PCI. Background. Emerging evidence has suggested that transradial access (TRA) may be associated with lower rates of acute kidney injury (AKI) as compared with transfemoral access (TFA). However, most of these studies have included a nonselected study population undergoing diagnostic cardiac catheterization or percutaneous coronary intervention (PCI). Data on the association between TRA and AKI in this setting of STEMI are limited and with conflicting results. Methods. We systematically searched PubMed, Embase, and Scopus for abstracts and full-text articles from inception to July 13th of 2021. Studies included were randomized controlled trials (RCTs) and propensity-score-matched (PSM) studies evaluating the association of TRA versus TFA access with AKI in patients undergoing primary PCI for STEMI. Data were integrated using the random effects model and generic inverse‐variance method of DerSimonian and Laird. Results. A total of 10,093 studies were found. After applying our inclusion criteria, 5 studies from 2014 to 2021 with a total of 8,536 STEMI patients were included. TRA was not significantly associated with a reduced risk for AKI compared with TFA (odds ratio 0.85, 95% CI 0.71–1.01, p 0.07, I2 = 40%). Conclusions. Transradial access was not significantly associated with lower risk of AKI in patients undergoing primary PCI for STEMI compared with TFA. Larger studies are needed to clarify this outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transradial versus Transfemoral Access and the Risk of Acute Kidney Injury following Primary Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies

Rio‐Pertuz

Juarez²,

Mekraksakit

et al. 2022

Journal of Interventional Cardiology

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“…AKI is a well-known complication after cardiac surgery. The incidence of postoperative AKI ranges from 8.9% to 48.5% in patients undergoing isolated CABG (8-12), and 7.1% to 21.5% in patients who undergo PCI procedures (13)(14)(15). Postoperative AKI is associated with significantly increased risks of in-hospital MI, mortality, and other severe perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

Risk factor analysis of acute kidney injury after one-stop hybrid coronary revascularization

Li¹,

Gao²,

Guo³

et al. 2021

Ann Palliat Med

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Background: One-stop hybrid coronary revascularization (HCR) combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures simultaneously. Acute kidney injury (AKI) is a common complication after CABG or PCI. This study explored the risk factors for developing AKI after one-stop HCR.Methods: A total of 123 consecutive patients who underwent one-stop HCR between April 2018 and November 2020 were included in this single-center retrospective study. Postoperative AKI was observed in 11 patients (the AKI group), and 112 patients did not develop postoperative AKI (the non-AKI group).Baseline characteristics and perioperative variables were extracted from the electronic medical records and statistically analyzed.Results: Postoperative AKI occurred in 11 (8.9%) patients. Compared to patients who did not develop AKI, patients in the AKI group were older (71.0±9.5 vs. 64.1±9.2 years, P=0.019), had higher preoperative creatinine levels (92.6±16.8 vs. 69.8±14.4 mmol/L, P<0.001), experienced a greater volume of postoperative drainage on the first day [850 mL (410, 1,500) vs. 500 mL (321, 700), P=0.045], had a higher proportion of chronic renal insufficiency (eGFR <60 mL/min/1.73 m 2 ) (36.4% vs. 7.1%, P=0.012), and had more perioperative transfusions (63.6% vs. 22.3%, P=0.007). Multivariate logistics analyses revealed that advanced age [odds ratio (OR) 5.44, P=0.014] and perioperative transfusions (OR 4.62, P=0.028) were independent risk factors for developing AKI after one-stop HCR.Conclusions: One-stop HCR did not increase the incidence of postoperative AKI in our center. Advanced age (≥75 years) and perioperative transfusions were independent risk factors for developing AKI after onestop HCR. Further studies need to be conducted to confirm the risk factors of AKI after HCR procedures.

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2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease

Virani,

Newby,

Arnold

et al. 2023

Journal of the American College of Cardiology

159

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Acute kidney injury after radial or femoral artery access in ST-segment elevation myocardial infarction: AKI-SAFARI

Cited by 11 publications

References 37 publications

Transradial versus Transfemoral Access and the Risk of Acute Kidney Injury following Primary Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies

Transradial versus Transfemoral Access and the Risk of Acute Kidney Injury following Primary Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies

Risk factor analysis of acute kidney injury after one-stop hybrid coronary revascularization

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease

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