Contrast use in relation to the arterial access site for percutaneous coronary intervention: A comprehensive meta-analysis of randomized trials

Shah, Rahman; Mattox, Anthony; Khan, Mahmood; Berzingi, Chalak; Rashid, Abdul

doi:10.4330/wjc.v9.i4.378

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Second, increasing amounts of contrast are associated with an increasing likelihood of developing AKI especially in those with impaired renal function [8]. It has been suggested that overall larger amounts of contrast are used with FA access, but this was not found in a metaanalysis of randomized trials comparing contrast use between RA and FA access [35]. Before adjustment, our FA group had approximately 15 ml more contrast used, but after adjustment, this was reduced to approximately 6 ml, an amount unlikely to have a clinical efect.…”

Section: Discussionmentioning

confidence: 99%

Association of Radial Artery Access with Reduced Incidence of Acute Kidney Injury

Kietrsunthorn

Locklear

Fonner³

et al. 2023

Journal of Interventional Cardiology

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Objectives. To determine if radial artery (RA) access compared with femoral artery (FA) access for percutaneous coronary intervention (PCI) is associated with a lower incidence of acute kidney injury (AKI). Background. AKI results in substantial morbidity and cost following PCI. Prior studies comparing the occurrence of AKI associated with radial artery (RA) versus femoral artery (FA) access have mixed results. Methods. Using a large state-wide database, 14,077 patients (8,539 with RA and 5,538 patents with FA access) were retrospectively compared to assess the occurrence of AKI following PCI. To reduce selection bias and balance clinical data across the two groups, a novel machine learning method called a Generalized Boosted Model was conducted on the arterial access site generating a weighted propensity score for each variable. A logistic regression analysis was then performed on the occurrence of AKI following PCI using the weighted propensity scores from the Generalized Boosted Model. Results. As shown in other studies, multiple variables were associated with an increase in AKI after PCI. Only RA access (OR 0.82; 95% CI 0.74–0.91) and male gender (OR 0.80; 95% CI 0.72–0.89) were associated with a lower occurrence of AKI. Based on the calculated Mehran scores, patients were stratified into groups with an increasing risk of AKI. RA access was consistently found to have a lower risk of AKI compared with FA access across these groups of increasing risk. Conclusions. Compared with FA access, RA access is associated with an 18% lower rate of AKI following PCI. This effect was observed among different levels of risk for developing AKI. Although developed from a retrospective analysis, this study supports the use of RA access when technically possible in a diverse group of patients.

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Section: Discussionmentioning

confidence: 99%

Association of Radial Artery Access with Reduced Incidence of Acute Kidney Injury

Kietrsunthorn

Locklear

Fonner³

et al. 2023

Journal of Interventional Cardiology

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“…Benefits for use of CMR (gender neutral evidence) CMR provides significant incremental value to conventional tests in establishing an accurate diagnosis [ 25 – 27 ] and prognosis in ACS [ 28 ]. CMR plays an important role in the contemporary assessment and prognosis of MINOCA [ 26 , 29 – 31 ].…”

Section: Imaging Females With Acute Coronary Syndromementioning

confidence: 99%

Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR)

Ordovás

Baldassarre

Bucciarelli-Ducci

et al. 2021

Journal of Cardiovascular Magnetic Resonance

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This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. The statements of clinical utility presented in the current document pertain to the following clinical scenarios: acute coronary syndrome, stable ischemic heart disease, peripartum cardiomyopathy, cancer therapy-related cardiac dysfunction, aortic syndrome and congenital heart disease in pregnancy, bicuspid aortic valve and aortopathies, systemic rheumatic diseases and collagen vascular disorders, and cardiomyopathy-causing mutations. The authors cite published evidence when available and provide expert consensus otherwise. Most of the evidence available pertains to translational studies involving subjects of both sexes. However, the authors have prioritized review of data obtained from female patients, and direct comparison of CMR between women and men. This position statement does not consider CMR accessibility or availability of local expertise, but instead highlights the optimal utilization of CMR in women with known or suspected cardiovascular disease. Finally, the ultimate goal of this position statement is to improve the health of female patients with cardiovascular disease by providing specific recommendations on the use of CMR.

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Radial access protects from contrast media induced nephropathy after cardiac catheterization procedures

et al. 2017

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Contrast use in relation to the arterial access site for percutaneous coronary intervention: A comprehensive meta-analysis of randomized trials

Cited by 5 publications

References 25 publications

Association of Radial Artery Access with Reduced Incidence of Acute Kidney Injury

Association of Radial Artery Access with Reduced Incidence of Acute Kidney Injury

Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR)

Radial access protects from contrast media induced nephropathy after cardiac catheterization procedures

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