PMID- 34491323
OWN - NLM
STAT- MEDLINE
DCOM- 20211221
LR  - 20211221
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 10
IP  - 10
DP  - 2021 Dec 18
TI  - Acute kidney injury in patients with acute coronary syndrome undergoing invasive 
      management treated with bivalirudin vs. unfractionated heparin: insights from the 
      MATRIX trial.
PG  - 1170-1179
LID - 10.1093/ehjacc/zuab080 [doi]
AB  - AIMS: Acute kidney injury (AKI) is a critical complication among patients with 
      acute coronary syndrome (ACS) undergoing invasive management. The value of 
      adjunctive antithrombotic strategies, such as bivalirudin or unfractionated 
      heparin (UFH) on the risk of AKI is unclear. METHODS AND RESULTS: Among 7213 
      patients enrolled in the MATRIX-Antithrombin and Treatment Duration study, 128 
      subjects were excluded due to incomplete information on serum creatinine (sCr) or 
      end-stage renal disease on dialysis treatment. The primary endpoint was AKI 
      defined as an absolute (>0.5 mg/dL) or a relative (>25%) increase in sCr. AKI 
      occurred in 601 patients (16.9%) treated with bivalirudin and 616 patients 
      (17.4%) treated with UFH [odds ratio (OR): 0.97; 95% confidence interval (CI): 
      0.85-1.09; P = 0.58]. A >25% sCr increase was observed in 597 patients (16.8%) 
      with bivalirudin and 616 patients (17.4%) with UFH (OR: 0.96; 95% CI: 0.85-1.08; 
      P = 0.50), whereas a >0.5 mg/dL absolute sCr increase occurred in 176 patients 
      (5.0%) with bivalirudin vs. 189 patients (5.4%) with UFH (OR: 0.92; 95% CI: 
      0.75-1.14; P = 0.46). By implementing the Kidney Disease Improving Global 
      Outcomes (KDIGO) criteria, the risk of AKI was not significantly different 
      between bivalirudin and UFH groups (OR: 0.88; 95% CI: 0.72-1.07; P = 0.21). 
      Subgroup analyses of the primary endpoint suggested a benefit with bivalirudin in 
      patients randomized to femoral access. CONCLUSION: Among ACS patients undergoing 
      invasive management, the risk of AKI was not significantly lower with bivalirudin 
      compared with UFH. TRIAL REGISTRATION: clinicaltrials.gov NCT01433627.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
FAU - Landi, Antonio
AU  - Landi A
AUID- ORCID: 0000-0002-0412-1083
AD  - Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale 
      (EOC), Via Tesserete, 48, CH-6900 Lugano, Switzerland.
FAU - Branca, Mattia
AU  - Branca M
AD  - CTU Bern, University of Bern, Bern, Switzerland.
FAU - Ando, Giuseppe
AU  - Ando G
AD  - Department of Clinical and Experimental Medicine, Azienda Ospedaliera 
      Universitaria Policlinico "Gaetano Martino", University of Messina, Messina, 
      Italy.
FAU - Russo, Filippo
AU  - Russo F
AD  - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, 
      Italy.
FAU - Frigoli, Enrico
AU  - Frigoli E
AD  - CTU Bern, University of Bern, Bern, Switzerland.
FAU - Gargiulo, Giuseppe
AU  - Gargiulo G
AUID- ORCID: 0000-0003-4395-6742
AD  - Department of Advanced Biomedical Science, University of Naples Federico II, 
      Naples, Italy.
FAU - Briguori, Carlo
AU  - Briguori C
AD  - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy.
FAU - Vranckx, Pascal
AU  - Vranckx P
AD  - Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa 
      Ziekenhuis, Hasselt, Belgium.
AD  - Faculty of Medicine and Life Sciences, University of Hasselt, Hasselt, Belgium.
FAU - Leonardi, Sergio
AU  - Leonardi S
AUID- ORCID: 0000-0002-4800-6132
AD  - Coronary Care Unit, Department of Molecular Medicine, University of Pavia and 
      Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
FAU - Gragnano, Felice
AU  - Gragnano F
AD  - Division of Cardiology, "Sant'Anna e San Sebastiano" Hospital, Caserta, Italy.
AD  - Department of Translational Medicine, University of Campania "Luigi Vanvitelli", 
      Caserta, Italy.
FAU - Calabro, Paolo
AU  - Calabro P
AUID- ORCID: 0000-0002-5018-830X
AD  - Division of Cardiology, "Sant'Anna e San Sebastiano" Hospital, Caserta, Italy.
AD  - Department of Translational Medicine, University of Campania "Luigi Vanvitelli", 
      Caserta, Italy.
FAU - Campo, Gianluca
AU  - Campo G
AD  - Cardiology Unit, Cardiovascular Institute, Azienda Ospedaliero-Universitaria di 
      Ferrara, Cona, Italy.
FAU - Ambrosio, Giuseppe
AU  - Ambrosio G
AUID- ORCID: 0000-0002-9677-980X
AD  - Department of Cardiology, Azienda Ospedaliero-Universitaria "S. Maria Della 
      Misericordia", Perugia, Italy.
FAU - Santucci, Andrea
AU  - Santucci A
AD  - Department of Cardiology, Azienda Ospedaliero-Universitaria "S. Maria Della 
      Misericordia", Perugia, Italy.
FAU - Varbella, Ferdinando
AU  - Varbella F
AD  - Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3, Turin, Italy.
AD  - Cardiology Unit, Azienda Ospedaliera Universitaria San Luigi Gonzaga Orbassano, 
      Turin, Italy.
FAU - Zaro, Tiziana
AU  - Zaro T
AD  - Cardiology Division, A.O. Ospedale Civile di Vimercate (MB), Vimercate, Italy.
FAU - Heg, Dik
AU  - Heg D
AD  - CTU Bern, University of Bern, Bern, Switzerland.
FAU - Windecker, Stephan
AU  - Windecker S
AUID- ORCID: 0000-0003-2653-6762
AD  - Department of Cardiology, University of Bern, Bern, Switzerland.
FAU - Juni, Peter
AU  - Juni P
AUID- ORCID: 0000-0002-5985-0670
AD  - Department of Medicine and Institute of Health Policy, Management and Evaluation, 
      University of Toronto, Toronto, ON, Canada.
FAU - Pedrazzini, Giovanni
AU  - Pedrazzini G
AD  - Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale 
      (EOC), Via Tesserete, 48, CH-6900 Lugano, Switzerland.
FAU - Valgimigli, Marco
AU  - Valgimigli M
AD  - Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale 
      (EOC), Via Tesserete, 48, CH-6900 Lugano, Switzerland.
AD  - Department of Cardiology, University of Bern, Bern, Switzerland.
CN  - MATRIX Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01433627
GR  - The Medicines Company and Terumo/
GR  - Societa Italiana di Cardiologia Invasiva/
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - *Acute Coronary Syndrome/complications/drug therapy
MH  - *Acute Kidney Injury/epidemiology/etiology
MH  - Heparin/adverse effects
MH  - Hirudins
MH  - Humans
MH  - Peptide Fragments
MH  - Recombinant Proteins
OTO - NOTNLM
OT  - Acute coronary syndromes
OT  - Acute kidney injury
OT  - Unfractionated heparin
OT  -  Bivalirudin
EDAT- 2021/09/08 06:00
MHDA- 2021/12/22 06:00
CRDT- 2021/09/07 12:31
PHST- 2021/06/11 00:00 [received]
PHST- 2021/08/03 00:00 [revised]
PHST- 2021/08/24 00:00 [accepted]
PHST- 2021/09/08 06:00 [pubmed]
PHST- 2021/12/22 06:00 [medline]
PHST- 2021/09/07 12:31 [entrez]
AID - 6365848 [pii]
AID - 10.1093/ehjacc/zuab080 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2021 Dec 18;10(10):1170-1179. doi: 
      10.1093/ehjacc/zuab080.