title: Scientific foundation and possible implications for practice of the Minimizing Adverse Haemorrhagic Events by Transradial Access Site andSystemic Implementation of AngioX (MATRIX) trial.
abstract: Early invasive management and the use of combined antithrombotic therapies have decreased the risk of recurrent ischaemia in patients with acute coronary syndrome (ACS) but have also increased the bleeding risk. Transradial intervention (TRI) and bivalirudin infusion compared to transfemoral intervention (TFI) or unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPI) decrease bleeding complications in patients with ACS. To what extent, a bleeding preventive strategy incorporating at least one of these two treatment options translates into improved outcomes is a matter of debate. The Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX study is a large-scale, multicenter, prospective, open-label trial, conducted at approximately 100 sites in Europe aiming to primarily assess whether TRI and bivalirudin infusion, as compared to TFI and UFH plus provisional GPI, decrease the 30-day incidence of death, myocardial infarction or stroke across the whole spectrum of ACS patients.
authors.affiliation: Thoraxcenter, Ba 587, Erasmus MC, Rotterdam, The Netherlands, m.valgimigli@erasmusmc.nl.
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.forename: Bernardo
authors.initials: B
authors.lastname: Cortese
authors.forename: Enrico
authors.initials: E
authors.lastname: Frigoli
authors.forename: Stefano
authors.initials: S
authors.lastname: Garducci
authors.forename: Paolo
authors.initials: P
authors.lastname: Rubartelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Andò
authors.forename: Andrea
authors.initials: A
authors.lastname: Santarelli
authors.forename: Mario
authors.initials: M
authors.lastname: Galli
authors.forename: Roberto
authors.initials: R
authors.lastname: Garbo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Repetto
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ierna
authors.forename: Carlo
authors.initials: C
authors.lastname: Briguori
authors.forename: Ugo
authors.initials: U
authors.lastname: Limbruno
authors.forename: Roberto
authors.initials: R
authors.lastname: Violini
authors.forename: Andrea
authors.initials: A
authors.lastname: Gagnor
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D000991:Antithrombins / Q000008:administration & dosage* / Q000009:adverse effects; D002985:Clinical Protocols; D004359:Drug Therapy, Combination; D005060:Europe; D005263:Femoral Artery; D006470:Hemorrhage / Q000139:chemically induced / Q000401:mortality / Q000517:prevention & control*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006629:Hirudins / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D010446:Peptide Fragments / Q000008:administration & dosage / Q000009:adverse effects; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors / Q000378:metabolism; D011446:Prospective Studies; D011677:Punctures; D017534:Radial Artery; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012107:Research Design; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin