Radial vs. Femoral Access for Angiography with or Without Bivalirudin in Patients with Acute Coronary Syndrome

A large, complex trial demonstrates fewer bleeding events with radial access and no benefit for bivalirudin at 1 year.

The MATRIX study includes three nested randomized trials conducted at 78 European hospitals to compare radial with femoral access, bivalirudin with heparin, and bivalirudin treatment durations in acute coronary syndrome (ACS) patients undergoing invasive management. Researchers enrolled 8404 patients (48% with ST-segment elevation myocardial infarction) in the access study; of these, 7213 and 3610 were included in the antithrombin and duration studies, respectively. Previously reported 30-day findings favored radial access (NEJM JW Cardiol May 2015 and Lancet 2015; 385:2465) and showed no overall benefit for bivalirudin (NEJM JW Cardiol Oct 2015 and N Engl J Med 2015; 373:997). Now, researchers report 1-year results.

Major adverse clinical e…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)