MATRIX: Radial vs. Femoral

Slides:



Advertisements
Similar presentations
Radial versus Femoral Randomized Investigation in ST Elevation Acute Coronary Syndrome the RIFLE STEACS study Enrico Romagnoli, MD PhD Principal investigators:
Advertisements

Trial profile Fox K et al. Lancet 2008;372:
Radial versus Femoral Access: RIVAL Objective:is radial access superior to femoral access Study:randomised, parallel group, multicenter trial Population:patients.
CHARM-Preserved: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved Purpose To determine whether the angiotensin.
TRI vs TFI in STEMI Shenyang Northern Hospital Wang Shouli Han Yalin.
Ho PM, et al. JAMA 2009;301: Baseline Characteristics of Patients Taking Clopidogrel After Hospital Discharge a Ho PM, et al. JAMA 2009;301:
Objective:To assess the effect of various clopidogrel and aspirin regimens on major CV events and ST in ACS patients undergoing PCI. Study:Multicenter,
Lancet 373: , 2009 Baseline Characteristics of Participants and Study Design of Clinical Trials to Compare Intensive glucose- lowering versus.
Bernardo Cortese, MD, FESC Intv’ Cardiology, A.O. Fatebenefratelli MI CNR-Fondazione Monasterio-Regione Toscana bernardocortese.com.
Date of download: 6/3/2016 From: Radial Versus Femoral Access in Invasively Managed Patients With Acute Coronary Syndrome: A Systematic Review and Meta-analysis.
The AURORA Trial Source: Holdaas H, Holme I, Schmieder RE, et al. Rosuvastatin in diabetic hemodialysis patient. J Am Soc Nephrol. 2011;22(7):1335–1341.
Summary of “A randomized trial of standard versus intensive blood-pressure control” The SPRINT Research Group, NEJM, DOI: /NEJMoa Downloaded.
(p for noninferiority = 0.01)
PRAGUE-18 Trial design: Patients with STEMI undergoing primary PCI were randomized to prasugrel (n = 634) versus ticagrelor (n = 596). Results (p = 0.94)
NORSTENT Trial design: Patients with obstructive coronary artery disease were randomized to a drug-eluting stent (DES) (n = 4,504) versus a bare-metal.
CORAL Trial design: Patients with renal artery stenosis and hypertension or chronic kidney disease were randomized to renal artery stenting (n = 467) vs.
SOCRATES Trial design: Patients with acute ischemic stroke were randomized in a 1:1 fashion to receive either ticagrelor 180 mg load + 90 mg BID or aspirin.
Scandinavian Simvastatin Survival Study (4S)
RE-CIRCUIT Trial design: Patients with atrial fibrillation undergoing catheter ablation were randomized to uninterrupted dabigatran 150 mg twice daily.
BENEFIT Trial design: Patients with positive serologic tests for T. Cruzi and cardiomyopathy were randomized to benznidazole 300 mg daily for days.
DANISH Trial design: Patients with nonischemic cardiomyopathy were randomized to ICD implantation (n = 556) versus usual care (n = 560). Results (p = 0.28)
EUCLID Trial design: Patients with peripheral arterial disease (PAD) were randomized to ticagrelor 90 mg twice daily (n = 6,930) vs. clopidogrel 75 mg.
ATLANTIC Trial design: Participants with STEMI being transported for primary PCI were randomized in the ambulance to ticagrelor 180 mg (n = 909) vs. placebo.
LEVO-CTS Trial design: Patients undergoing cardiac surgery with the use of cardiopulmonary bypass were randomized to infusion of levosimendan 0.2 µg/kg/min.
EMPA-REG OUTCOME Trial design: Patients with type 2 diabetes mellitus (DM2) at high risk for CV events were randomized to receive in a 1:1:1 fashion either.
Figure 3 Ischaemic outcomes in the ST-segment elevation myocardial
EVITA Trial design: Smokers admitted with an acute coronary syndrome were randomized to varenicline 1 mg twice daily (n = 151) vs. placebo (n = 151). Study.
MARFAN SARTAN Trial design: Marfan patients were randomized to losartan (n = 153) vs. placebo (n = 150). The dose of losartan was 50 mg for those
Losartan vs. Atenolol in Marfan Syndrome
POSEIDON-DCM Trial design: Patients with nonischemic dilated cardiomyopathy were randomized to transendocardial injection of allogenic (n = 18) vs. autologous.
Compare-Acute Trial design: STEMI patients undergoing primary PCI were randomized to fractional flow reserve (FFR)-guided complete revascularization (n.
PARADIGM-HF Trial design: Participants with NYHA class II-IV and LVEF ≤40% were randomized to LCZ mg twice daily (n = 4,187) vs. enalapril 10 mg.
PRECISION Trial design: Patients with arthritis and increased cardiovascular risk were randomized to celecoxib 100 mg twice daily (n = 8,072) vs. ibuprofen.
VALUE Trial design: Hypertensive patients at high cardiovascular risk were randomized to valsartan (n = 7,649) vs. amlodipine (n = 7,596). Results (p =
ANTARCTIC Trial design: Patients with acute coronary syndrome undergoing stenting were randomized to tailored antiplatelet therapy (n = 435) versus conventional.
SIGNIFY Trial design: Participants with stable coronary artery disease without clinical heart failure and resting heart rate >70 bpm were randomized to.
Figure 2 Ischaemic and bleeding outcomes in the major clinical trials
SMILE Trial design: NSTEMI patients were randomized to complete revascularization during the index procedure (i.e., 1-stage revascularization; n = 264)
FAMOUS-NSTEMI Trial design: Participants with NSTEMI were randomized to an FFR-guided strategy (n = 176) vs. a coronary angiography-guided strategy (n.
Relative risk of major events with atenolol vs placebo
SUSTAIN-6 Trial design: Patients with DM2 at high risk for CV events were randomized in a 1:1:1:1 fashion to either semaglutide 0.5 mg, semaglutide 1 mg,
PROCAMIO Trial design: Patients with hemodynamically stable wide complex monomorphic tachycardia were randomized 1:1 to either intravenous procainamide.
BASKET-SAVAGE Trial design: Patients with a SVG lesion were randomized to a DES (Taxus Liberte; n = 89) versus a BMS (Liberte; n = 84). All patients were.
BASKET-PROVE II Trial design: Subjects with stable or unstable coronary artery disease undergoing stent implantation were randomized to a biodegradable-polymer.
BAT for HFrEF Trial design: Patients with chronic systolic HF were randomized in a 1:1 fashion to either baroreceptor activation therapy (BAT) or control.
NIPPON Trial design: Patients undergoing percutaneous coronary intervention were randomized to short-term dual antiplatelet therapy (DAPT) (6 months; n.
ZEUS Trial design: Patients who were deemed uncertain DES candidates due to bleeding, thrombotic, or restenosis risk were randomized to receive either.
After Eighty Study Trial design: Elderly patients with non–ST-elevation acute coronary syndrome (NSTE-ACS) were randomized to invasive therapy (n = 229)
AFACT Trial design: Patients with long-standing atrial fibrillation were randomized to ganglion plexus ablation (n = 117) vs. control (n = 123) on top.
FOURIER Trial design: Patients with established cardiovascular disease on statin therapy were randomized to evolocumab 140 mg subcutaneous every 2 weeks.
(p = 0.32 for noninferiority)
(p < for noninferiority)
BRAVO-3 Trial design: Patients undergoing transfemoral TAVR were randomized in a 1:1 fashion to bivalirudin or UFH. They were followed for 30 days. Results.
OSLER Trial design: Patients from five phase 2 trials and seven phase 3 trials with evolocumab were invited to participate in the OSLER extension program,
(p for noninferiority < 0.001)
(p = for noninferiority)
CHAMPION Trial design: Patients with recent hospitalization for heart failure were implanted with a pulmonary artery pressure monitor and randomized so.
ARISE Trial Aggressive Reduction of Inflammation Stops Events
Comparison of radial versus femoral access in patients undergoing invasive management for acute coronary syndromes: evidence from a systematic review and.
SOLID-TIMI 52 Trial design: Participants within 30 days of an acute coronary syndrome (ACS) were randomized to darapladib 160 mg daily (n = 6,504) versus.
Primary safety endpoint
OPTIDUAL Trial design: Patients who received a drug-eluting stent and were event-free at 12 months were randomized to an additional 36 months of DAPT with.
MOMENTUM 3 Trial design: Patients with advanced heart failure were randomized to a centrifugal-flow pump (n = 152) vs. an axial-flow pump (n = 142). Results.
IVUS-XPL Trial design: Patients undergoing drug-eluting stent implantation for long coronary lesions were randomized to IVUS-guided PCI (n = 700) vs. angiography-guided.
(p for noninferiority = 0.01)
NOBLE Trial design: Patients with unprotected left main disease were randomized to either PCI with a drug-eluting stent (DES) (88% biolimus) or CABG. They.
Result of coronary angiogram among patients with and without diabetes admitted with first-time acute coronary syndrome (a significant stenosis was defined.
CIRCUS Trial design: Patients with anterior STEMI were randomized to IV cyclosporine 2.5 mg/kg (n = 475) vs. placebo (n = 495) immediately before coronary.
Section C: Clinical trial update: Oral antiplatelet therapy
Adjusted. ORs for outcomes by maintenance P2Y12 treatment
Presentation transcript:

MATRIX: Radial vs. Femoral Trial design: Subjects with acute coronary syndromes were randomized to radial access (n = 4,197) vs. femoral access (n = 4,207). Results (p = 0.031) Death, MI, or stroke: 8.8% of the radial group vs. 10.3% of the femoral group (p = 0.031; this exceeded the prespecified α level of 2.5%) Death, MI, stroke, or BARC (type 3 or 5) major bleeding: 9.8% vs. 11.7% (p = 0.0092), respectively, for radial vs. femoral 10.3 % 8.8 Conclusions Among patients with acute coronary syndromes, radial access was not associated with a reduction in major adverse cardiovascular events However, radial access was associated with a reduction in net adverse events, including major bleeding Radial access Femoral access Valgimigli M, et al. Lancet 2015;Mar 13:[Epub]