Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial
Lancet
; 377(9775): 1409-1420, 2011. ilus, tab
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1064569
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
Background Small trials have suggested that radial access for percutaneous coronary intervention (PCI) reducesvascular complications and bleeding compared with femoral access. We aimed to assess whether radial access was superior to femoral access in patients with acute coronary syndromes (ACS) who were undergoing coronaryangiography with possible intervention.Methods The RadIal Vs femorAL access for coronary intervention (RIVAL) trial was a randomised, parallel group,multicentre trial. Patients with ACS were randomly assigned (11) by a 24 h computerised central automated voiceresponse system to radial or femoral artery access. The primary outcome was a composite of death, myocardialinfarction, stroke, or non-coronary artery bypass graft (non-CABG)-related major bleeding at 30 days. Key secondary outcomes were death, myocardial infarction, or stroke; and non-CABG-related major bleeding at 30 days. A masked central committee adjudicated the primary outcome, components of the primary outcome, and stent thrombosis. All other outcomes were as reported by the investigators. Patients and investigators were not masked to treatment allocation. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, NCT01014273. Findings Between June 6, 2006, and Nov 3, 2010, 7021 patients were enrolled from 158 hospitals in 32 countries.3507 patients were randomly assigned to radial access and 3514 to femoral access. The primary outcome occurred in128 (3·7%) of 3507 patients in the radial access group compared with 139 (4·0%) of 3514 in the femoral access group (hazard ratio [HR] 0·92, 95% CI 0·721·17; p=0·50). Of the six prespecifi ed subgroups, there was a signifi cant interaction for the primary outcome with benefi t for radial access in highest tertile volume radial centres (HR 0·49, 95% CI 0·280·87; p=0·015)...
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Ischemic Heart Disease
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Coronary Angiography
/
Radial Artery
/
Angioplasty
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Coronary Disease
/
Femoral Artery
Type of study:
Controlled clinical trial
Language:
English
Journal:
Lancet
Year:
2011
Document type:
Article
Institution/Affiliation country:
Charles University, Hospital Kralovske Vinohrady/CZ
/
Duke Clinical Research Institute, Duke University/US
/
Hospital Universitari Dr Peset/ES
/
INSERM U698 Recherche Clinique enAthérothrombose, Université Paris 7 and Assistance PubliqueHôpitaux de Paris/FR
/
Instituto Dante pazzanse de Cardiologia/BR
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Lady Davis Carmel Medical Center/IL
/
McMaster University and the Population Health Research Institute, Hamilton Health Sciences/CA
/
Postgraduate Medical School,Department of Cardiology, Grochowski Hospital/PL
/
St Johns Medical College and Research Institute/IN
/
Sunnybrook Health Sciences/CA