title: Efficacy of Radial Versus Femoral Access in the Acute Coronary Syndrome: Is it the Operator or the Operation That Matters?
abstract: In the recently published MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial, the use of transradial access (TRA) compared to transfemoral access (TFA) during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) was associated with a reduction in net adverse cardiovascular events. However, the results of MATRIX must be interpreted with caution due to several limitations including the strong modulating effect of operator/center experience on the relative efficacy of TRA and the inclusion of 2 distinct patient populations (ST-segment elevation and non-ST-segment elevation ACS). Therefore, although important, the results of MATRIX have strong limitations and are not sufficient to definitively identify an approach of choice during PCI for ACS. Further research is needed before strong, evidence-based recommendations regarding the approach of choice during PCI for ACS can be made.
authors.affiliation: University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address: mlemay@ottawaheart.ca.
authors.forename: Michel R
authors.initials: MR
authors.lastname: Le May
authors.affiliation: University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Kuljit
authors.initials: K
authors.lastname: Singh
authors.affiliation: University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002983:Clinical Competence; D019317:Evidence-Based Medicine; D005263:Femoral Artery; D006801:Humans; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011677:Punctures; D017534:Radial Artery; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: acute coronary syndrome(s); femoral approach; percutaneous coronary intervention; radial approach