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Cortese B - AIMRADIAL 2014 - Acute kidney injury

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Acute kidney injury - A european perspective. Comparison of risk of acute kidney injury following primary PCI with the transradial approach vs the transfemoral approach: The PRIPITENA Urban Registry.

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Cortese B - AIMRADIAL 2014 - Acute kidney injury

  1. 1. AKI-a european perspective Comparison of Risk of AKI Following Primary PCI with the Transradial Approach vs the Transfemoral Approach. The PRIPITENA Urban Registry. Cortese, Sciahbasi, Sebik, Rigattieri, Alonzo, Silva Orrego, Belloni, Seregni, Giovannelli, Tespili, Ricci, Berni Milano, Bergamo & Roma Bernardo Cortese Intv’ Cardiology, A.O. Fatebenefratelli bcortese@gmail.com
  2. 2. Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse have had a financial interest/arrangement or affiliation with the organizations listed below. Affiliation/Financial Relationship Company • Grant/Research Support • Consulting Fees/Honoraria • Advisory board • Movi, AB Medica • Cardionovum, Abbott Vascular, Hexacath, Astra Zeneca, Terumo • Medtronic/Invatec
  3. 3. AKI: a PCI problem 1.000.000 PCIs (National CV Data Registry) 20-30% in pts with preexisting RI Tsai TT, JACC Int ‘14 >1200 US hospitals 6.09-6.11 single PCI during hospitalization AKI definition: >0.3 mg/dl or >50% increase Cr
  4. 4. AKI: a PCI problem Tsai TT, JACC Int ‘14
  5. 5. Seeliger E, EHJ ‘12 AKI: a PCI problem
  6. 6. Kooiman J, Circ CI ‘14
  7. 7. The PRImary PCI from TEvere to NAvigli (PRIPITENA) registry is a multicenter italian consortium of expert primary PCI facilities from urban areas of Milano and Roma. The aim of our study was to evaluate, in the setting of primary PCI, the role of different vascular approaches for the occurrence of AKI (cr  25% or 0,5 mg/dl).
  8. 8. All STEMI patients undergone PPCI 2011-2013 w’in 12 hours (1330) TF (494) TR (836) occurrence of AKI (primary unadjusted analysis) propensity score matching: occurrence of AKI (PE) SE: MACE bleeds (major & minor TIMI) ST (ARC) B. Cortese et al, Am J Cardiol 9 14
  9. 9. clinical data B. Cortese et al, Am J Cardiol 9 14
  10. 10. AKI incidence: 8.1 vs. 16.9, p <0.0001 B. Cortese et al, Am J Cardiol 9 14
  11. 11. B. Cortese et al, Am J Cardiol 9 14
  12. 12. AKI incidence 8.4% 16.9% B. Cortese et al, Am J Cardiol 9 14
  13. 13. B. Cortese et al, Am J Cardiol 9 14
  14. 14. >AKI with transfemoral: why? 1-hypotension/hypovolemia due to bleeds 2-atheroembolism due to catheter manipulation in abdominal aorta
  15. 15. AKI: a PCI problem Stratta G, J Nephrol ‘12 CIN
  16. 16. study limitations B. Cortese et al, Am J Cardiol 9 14 1- multicenter retrospective DB 2- different habits among centers 3- short follow up (in-hospital)
  17. 17. conclusions this is the first report that shows a reduced incidence of AKI with the transradial approach vs the transfemoral one, in a high risk population with STEMI.
  18. 18. AKI-a european perspective Comparison of Risk of AKI Following Primary PCI with the Transradial Approach vs the Transfemoral Approach. The PRIPITENA Urban Registry. Cortese, Sciahbasi, Sebik, Rigattieri, Alonzo, Silva Orrego, Belloni, Seregni, Giovannelli, Tespili, Ricci, Berni Milano, Bergamo & Roma Bernardo Cortese Intv’ Cardiology, A.O. Fatebenefratelli bcortese@gmail.com

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