Background:Percutaneous coronary intervention is now the best way of management of acute coronary syndrome (ACS). Contrast induced nephropathy is a serious complication and greatly dependent on several factors. It is still unclear whether the vascular access migrates CIN risk.Objective:To study the impact of Radial Access (RA) compared with Femoral Access (FA) on developing contrast-induced nephropathy (CIN) in patients undergoing invasive management of acute coronary syndrome (ACS).Methods: Sixty patients eligible for invasive management of ACS at cardiology department (Menoufia University hospital and National Heart Institute) were randomized into two groups.Group I: included 30 patients with femoral approach and Group II: included 30 patients with radial approach. The occurrence of CIN estimated by KDIGO definition (absolute increase in serum creatinine (SCr) by ≥0.5 mg/dl within 48 hours; or increase in SCr to ≥25% of baseline) was estimated in both groups. Results:Only 9 patients (15%) developed CIN, 5 patients (55.6%) of them underwent PCI through FA without statistically significant difference between the two approaches.Conclusion: CIN is considered a potential complication of percutaneous coronary intervention (PCI).Our study did not show the preference of using an approach over the other.
References
[1]
Thygesen, K., Alpert, J.S., Jaffe, A.S., et al. (2012) Third Universal Definition of Myocardial Infarction. Circulation, 126, 2020-2035.
https://doi.org/10.1161/CIR.0b013e31826e1058
[2]
Antman, E.M., Tanasijevic, M.J., Thompson, B., Schactman, M., McCabe, C.H., Cannon, C.P., et al. (1996) Cardiac-Specific Troponin I Levels to Predict the Risk of Mortality in Patients with Acute Coronary Syndromes. The New England Journal of Medicine, 335, 1342-1349. https://doi.org/10.1056/NEJM199610313351802
[3]
Heidenreich, P.A., Alloggiamento, T., Melsop, K., McDonald, K.M., Go, A.S. and Hlatky, M.A. (2001) The Prognostic Value of Troponin in Patients with Non-ST Elevation Acute Coronary Syndromes: A Meta-Analysis. Journal of the American College of Cardiology, 38, 478-485. https://doi.org/10.1016/S0735-1097(01)01388-2
[4]
Keller, T., Zeller, T., Ojeda, F., et al. (2011) Serial Changes in Highly Sensitive Troponin I Assay and Early Diagnosis of Myocardial Infarction. JAMA, 306, 2684-2493.
https://doi.org/10.1001/jama.2011.1896
[5]
Damman, P., Holmvang, L., Tijssen, J.G., et al. (2012) Usefulness of the Admission Electrocardiogram to Predict Long-Term Outcomes after Non-ST-Elevation Acute Coronary Syndrome (from the FRISC II, ICTUS, and RITA-3 [FIR] Trials). American Journal of Cardiology, 109, 6-12. https://doi.org/10.1016/j.amjcard.2011.08.002
[6]
Keeley, E.C., Boura, J.A. and Grines, C.L. (2003) Primary Angioplasty versus Intravenous Thrombolytic Therapy for Acute Myocardial Infarction: A Quantitative Review of 23 Randomised Trials. The Lancet, 361, 13-20.
https://doi.org/10.1016/S0140-6736(03)12113-7
[7]
Tavakol, M., Ashraf, S. and Brener, S.J. (2012) Risks and Complications of Coronary Angiography: A Comprehensive Review. Global Journal of Health Science, 4, 65-93.
https://doi.org/10.5539/gjhs.v4n1p65
[8]
Bhatty, S., Cooke, R., Shetty, R., et al. (2011) Femoral Vascular Access-Site Complications in the Cardiac Catheterization Laboratory: Diagnosis and Management. Interventional Cardiology Journal, 3, 503-514. https://doi.org/10.2217/ica.11.49
[9]
Azzalini, L., Candilio, L., McCullough, P.A., et al. (2017) Current Risk of Contrast-Induced Acute Kidney Injury after Coronary Angiography and Intervention: A Reappraisal of the Literature. Canadian Journal of Cardiology, 33, 1225-1228.
https://doi.org/10.1016/j.cjca.2017.07.482
[10]
Ribichini, F., Graziani, M., Gambaro, G., et al. (2010) Early Creatinine Shifts Predict Contrast-Induced Nephropathy and Persistent Renal Damage after Angiography. The American Journal of Medicine, 123, 755-763.
https://doi.org/10.1016/j.amjmed.2010.02.026
[11]
Barrett, B.J. and Parfrey, P.S. (2006) Clinical Practice. Preventing Nephropathy Induced by Contrast Medium. The New England Journal of Medicine, 354, 379-386.
https://doi.org/10.1056/NEJMcp050801
[12]
Samul, W., Turowska, A., Kwasiborski, P.J., Kowalczyk, P. and Cwetsch, A. (2015) Comparison of Safety of Radial and Femoral Approaches for Coronary Catheterization in Interventional Cardiology. Medical Science Monitor, 21, 1464-1468.
https://doi.org/10.12659/MSM.893193
[13]
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, J.M., 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. and MATRIX Investigators (2017) Acute Kidney Injury after Radial or Femoral Access for Invasive Acute Coronary Syndromes Management: AKI-MATRIX. Journal of the American College of Cardiology, pii: S0735-1097(17)36897-3.
[14]
Roth, G.A., Forouzanfar, M.H., Moran, A.E., Barber, R., Nguyen, G., Feigin, V.L., et al. (2015) Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality. The New England Journal of Medicine, 372, 1333-1341.
https://doi.org/10.1056/NEJMoa1406656
[15]
Bartholomew, B.A., Harjai, K.J., Dukkipati, S., et al. (2004) Impact of Nephropathy after Percutaneous Coronary Intervention and a Method for Risk Stratification. American Journal of Cardiology, 93, 1515-1519.
https://doi.org/10.1016/j.amjcard.2004.03.008
[16]
Nash, K., Hafeez, A. and Hou, S. (2002) Hospital-Acquired Renal Insufficiency. American Journal of Kidney Diseases, 39, 930-936.
https://doi.org/10.1053/ajkd.2002.32766
[17]
Kellum, J., Lameire, N., Aspelin, P., et al. (2012) KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International, 2, 1-138.
[18]
Marenzi, G., Lauri, G., Assanelli, E., Campodonico, J., De Metrio, M., Marana, I., Grazi, M., Veglia, F. and Bartorelli, A.L. (2004) Contrast-Induced Nephropathy in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction. Journal of the American College of Cardiology, 44, 1780-1785.
https://doi.org/10.1016/j.jacc.2004.07.043
[19]
Rihal, C.S., Textor, S.C., Grill, D.E., et al. (2002) Incidence and Prognostic Importance of Acute Renal Failure after Percutaneous Coronary Intervention. Circulation, 105, 2259-2264. https://doi.org/10.1161/01.CIR.0000016043.87291.33
[20]
Aspelin, P., Aubry, P., Fransson, S.G., Strasser, R., Willenbrock, R., et al. (2003) Nephrotoxic Effects in High-Risk Patients Undergoing Angiography. New England Journal of Medicine, 348, 491-499. https://doi.org/10.1056/NEJMoa021833
[21]
Barbieri, L., Verdoia, M., Nardin, M., Marino, P., Suryapranata, H., De Luca, G. and Novara Atherosclerosis Study Group (NAS) (2017) Gender Difference in the Risk of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention. Angiology, 68, 542-546.
https://doi.org/10.1177/0003319716669429
[22]
Kolte, D., Spence, N., Puthawala, M., Hyder, O., Tuohy, C.P., Davidson, C.B., et al. (2016) Association of Radial versus Femoral Access with Contrast-Induced Acute Kidney Injury in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction. Cardiovascular Revascularization Medicine, 17, 546-551. https://doi.org/10.1016/j.carrev.2016.07.008
[23]
Valgimigli, M., Gagnor, A., Calabro, P., Frigoli, E., Leonardi, S., Zaro, T., Rubartelli, P., Briguori, C., Ando, G., Repetto, A., Limbruno, U., Cortese, B., Sganzerla, P., Lupi, A., Galli, M., Colangelo, S., Ierna, S., Ausiello, A., Presbitero, P., Sardella, G., Varbella, F., Esposito, G., Santarelli, A., Tresoldi, S., Nazzaro, M., Zingarelli, A., de Cesare, N., Rigattieri, S., Tosi, P., Palmieri, C., Brugaletta, S., Rao, S.V., Heg, D., Rothenbuhler, M., Vranckx, P., Juni, P. and Investigators, M. (2015) Radial versus Femoral Access in Patients with Acute Coronary Syndromes Undergoing Invasive Management: A Randomisedmulticentre Trial. The Lancet, 385, 2465-2476.
https://doi.org/10.1016/S0140-6736(15)60292-6
[24]
Vora, A.N., Stanislawski, M., Grunwald, G.K., Plomondon, M.E., Rumsfeld, J.S., Maddox, T.M., Vidovich, M.I., Woody, W., Nallamothu, B.K., Gurm, H.S. and Rao, S.V. (2017) Association between Chronic Kidney Disease and Rates of Transfusion and Progression to End-Stage Renal Disease in Patients Undergoing Transradial versus Transfemoral Cardiac Catheterization—An Analysis from the Veterans Affairs Clinical Assessment Reporting and Tracking (CART) Program. Journal of the American Heart Association, 6, e004819. https://doi.org/10.1161/JAHA.116.004819
[25]
Feldman, D.N., Swaminathan, R.V., Kaltenbach, L.A., Baklanov, D.V., Kim, L.K., Wong, S.C., Minutello, R.M., Messenger, J.C., Moussa, I., Garratt, K.N., et al. (2013) Adoption of Radial Access and Comparison of Outcomes to Femoral Access in Percutaneous Coronary Intervention: An Updated Report from the National Cardiovascular Data Registry (2007-2012). Circulation, 127, 2295-2306.
https://doi.org/10.1161/CIRCULATIONAHA.112.000536
[26]
Cortese, B., Sciahbasi, A., Sebik, R., Rigattieri, S., Alonzo, A., Silva-Orrego, P., et al. (2014) 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). American Journal of Cardiology, 114, 820-825. https://doi.org/10.1016/j.amjcard.2014.06.010
[27]
Marenzi, G., Assanelli, E., Campodonico, J., Lauri, G., Marana, I., De Metrio, M., et al. (2009) Contrast Volume during Primary Percutaneous Coronary Intervention and Subsequent Contrast-Induced Nephropathy and Mortality. Annals of Internal Medicine, 150, 170-177. https://doi.org/10.7326/0003-4819-150-3-200902030-00006
[28]
Romagnoli, E., Biondi-Zoccai, G., Sciahbasi, A., et al. (2012) Radial versus Femoral Randomized Investigation in ST-Segment Elevation Acute Coronary Syndrome: The RIFLE-STEACS (Radial versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) Study. Journal of the American College of Cardiology, 60, 2481-2489. https://doi.org/10.1016/j.jacc.2012.06.017
