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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 angio X ) sub‐study
Author(s) -
Andò Giuseppe,
Cortese Bernardo,
Frigoli Enrico,
Gagnor Andrea,
Garducci Stefano,
Briguori Carlo,
Rubartelli Paolo,
Calabrò Paolo,
Valgimigli Marco
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25932
Subject(s) - medicine , percutaneous coronary intervention , acute kidney injury , bivalirudin , conventional pci , acute coronary syndrome , cardiology , randomized controlled trial , intensive care medicine , cardiac catheterization , myocardial infarction
Acute kidney injury (AKI) is an important complication of both diagnostic cardiac catheterization and percutaneous coronary intervention (PCI). A large body of evidence supports that AKI is related to volume of contrast used. Despite several measures are available to reduce the impact of contrast media on AKI, its incidence remains significant as other mechanisms of renal damage are involved. A new paradigm is established according to which bleeding prevention is at least as important as preventing recurrent ischemic events in the management of patients with acute coronary syndromes (ACS) undergoing an invasive approach. Periprocedural bleeding, which is consistently reduced by radial approach, is emerging as a risk factor for the development of AKI. Therefore, the role of vascular access as a measure to prevent AKI needs to be systematically assessed in randomized studies. To date, no prospective comparison on renal outcomes has been carried out in randomized trials between radial and femoral approach. The M inimizing A dverse hemorrhagic events by TR ansradial access site and systemic I mplementation of Angio X (MATRIX) trial (ClinicalTrials.gov identifier: NCT01433627) has been designed to test whether to minimize bleeding events by using radial access and bivalirudin, across the whole spectrum of patients with ACS undergoing PCI, will result in improved outcomes with respect to both ischemic and bleeding complications. The AKI‐MATRIX sub‐study will provide a unique opportunity to assess whether the advantages of radial approach may even contribute to the reduction of the risk of AKI in patients with ACS. © 2015 Wiley Periodicals, Inc.