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

Andò, Giuseppe; Cortese, Bernardo; Russo, Filippo; Rothenbühler, Martina; Frigoli, Enrico; Gargiulo, Giuseppe; Briguori, Carlo; Vranckx, Pascal; Leonardi, Sergio; Guiducci, Vincenzo; Belloni, Flavia; Ferrari, Fabio; Hernández, José M. de la Torre; Curello, Salvatore; Liïstro, Francesco; Perkan, Andrea; Servi, Stefano De; 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; Investigators, Matrix

doi:10.1016/j.jacc.2017.02.070

Cited by 140 publications

(95 citation statements)

References 27 publications

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“…The role of P2Y12 receptor antagonists in AKI is strongly confounded by the clinical characteristics and still needs to be determined. Radial access was shown to be protective for AKI, which is consistent with previous reports [16]. …”

Section: Discussionsupporting

confidence: 91%

“…Bleeding after PCI more frequently complicated hospitalization in patients with AKI (unadjusted OR: 8.95; 95% CI: 7.06–11.09; p < 0.0001) and also predicted AKI, as previously seen [16, 18, 21, 22]. …”

Section: Discussionsupporting

confidence: 69%

“…A graded increase in the severity of AKI according to the KDIGO definition is associated with a progressively increased risk of long-term mortality in these patients. The prevalence of AKI was lower than in similar trials, probably because less contrast was used and good hydration was maintained in our study to prevent AKI [16]. Unfortunately, comparison is difficult due to the different study populations and different definitions of AKI and comparisons must be made in light of these differences.…”

Section: Discussionmentioning

confidence: 72%

“…Therefore, we must obtain the serum creatinine value at hospital admission. We can easily define the patients who are prone to develop AKI (eGFR < 60 mL/min/1.73 m 2 , hemodynamic impairment, STEMI, diabetes, hypertension, hyperlipidemia, elderly) [1, 3-5] and instigate early nephroprotective strategies (low contrast volume, crystalloid infusions, measures to ensure optimal hemodynamics, discontinuation of nephrotoxic drugs, adjustment of anti-thrombotic drugs, radial access), which might provide a significant long-term benefit [5, 7, 16, 24, 25]. In cases of AKI, the consultation with a nephrologist would be beneficial for these patients.…”

Section: Discussionmentioning

confidence: 99%

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Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

et al. 2018

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Background: There are limited data regarding the incidence and long-term impact of acute kidney injury (AKI) according to the KDIGO guidelines on the outcome in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI). The aim of the study was to evaluate the prevalence of AKI, as classified by the KDIGO criteria, and its association with long-term mortality. Methods: Data from 5,859 MI patients undergoing PCI at our institution were analyzed. We compared the group without and with AKI according to the KDIGO criteria in relation to long-term mortality. Results: AKI was documented in 499 (8.5%) patients. AKI stage 1 occurred in 6.2% of patients, AKI stage 2 in 0.9% of patients, and AKI stage 3 in 1.5% of patients. Patients with AKI had a higher long-term mortality (57.3 vs. 20.6%; p < 0.0001). The mortality was 50.3% in AKI stage 1, 56.9% in AKI stage 2, and 87.2% in AKI stage 3. The hazard ratios for all-cause mortality for AKI stages 1–3 were 1.77, 1.85, and 6.30 compared to patients with no AKI. Cardiogenic shock, bleeding, heart failure, age, renal dysfunction, diabetes, hyperlipidemia, ST-elevation MI, contrast volume/glomerular filtration ratio, P2Y12 receptor antagonists, and radial access were associated with the development of AKI. Conclusion: A slight increase in serum creatinine was associated with a progressive increase in long-term mortality in patients with AKI according to the KDIGO definition.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

et al. 2018

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“…They also showed lower risk of bleeding and a trend toward lower nephropathy requiring dialysis risk with transradial approach. Recently, data were reported from AKI‐MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox), the only large, randomized, multicenter, trial that looked at the impact of access route and renal function with cardiac catheterization . This trial compared the incidence of AKI with the radial approach versus the femoral approach in patients with myocardial infarction with or without ST‐segment elevation who underwent coronary angiography, and if indicated a PCI.…”

Section: Resultsmentioning

confidence: 99%

Cholesterol embolization syndrome: An under‐recognized entity in cardiovascular interventions

Agrawal

Ziccardi

Witzke

et al. 2017

J Interven Cardiology

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Cholesterol embolization syndrome (CES) is a multi-systemic disease caused by embolization of atherosclerotic plaque contents from proximal large-caliber artery to distal small to medium arteries, occurring spontaneously or more commonly after vascular intervention. This report is a comprehensive review of the reported cases of CES found in our literature search. We discuss the risk factors, clinical manifestations, management, and prognosis of CES. The major predisposing factors for CES include older age, male sex, atherosclerotic cardiovascular risk factors, anticoagulation, and femoral access route. The composite incidence of atheroembolic renal disease was 92% and mortality 63%. Our review highlights the importance to recognize this disease entity for the cardiologist and nephrologist.

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Transradial versus transfemoral approach for diagnostic coronary angiography and percutaneous coronary intervention in people with coronary artery disease

Kolkailah

Alreshq

Muhammed

et al. 2018

Cochrane Database of Systematic Reviews

122

119

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

Abstract: 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).

Cited by 140 publications

References 27 publications

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

Cholesterol embolization syndrome: An under‐recognized entity in cardiovascular interventions

Transradial versus transfemoral approach for diagnostic coronary angiography and percutaneous coronary intervention in people with coronary artery disease

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