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Assessing the cardiology community position on transradial intervention and the use of bivalirudin in patients with acute coronary syndrome undergoing invasive management: Results of an EAPCI survey   
Yazarlar
Marianna Adamo
Erasmus MC, Netherlands
Robert A. Byrne
Technische Universität München, Germany
Andreas Baumbach
University Hospitals Bristol and Weston NHS Foundation Trust, United Kingdom
Michael Haude
Städt. Kliniken Neuss - Lukaskrankenhaus GmbH, Germany
Stephan Windecker
University Hospital Bern, Switzerland
Marco Valgimigli
Erasmus MC, Netherlands
Özet
Aims: Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) collecting the opinion of the cardiology community on the invasive management of acute coronary syndrome (ACS), before and after the MATRIX trial presentation at the American College of Cardiology (ACC) 2015 Scientific Sessions. Methods and results: A web-based survey was distributed to all individuals registered on the EuroIntervention mailing list (n=15,200). A total of 572 and 763 physicians responded to the pre-and post-ACC survey, respectively. The radial approach emerged as the preferable access site for ACS patients undergoing invasive management with roughly every other responder interpreting the evidence for mortality benefit as definitive and calling for a guidelines upgrade to class I. The most frequently preferred anticoagulant in ACS patients remains unfractionated heparin (UFH), due to higher costs and greater perceived thrombotic risks associated with bivalirudin. However, more than a quarter of participants declared the use of bivalirudin would increase after MATRIX. Conclusions: The MATRIX trial reinforced the evidence for a causal association between bleeding and mortality and triggered consensus on the superiority of the radial versus femoral approach. The belief that bivalirudin mitigates bleeding risk is common, but UFH still remains the preferred anticoagulant based on lower costs and thrombotic risks.
Anahtar Kelimeler
Acute coronary syndrome | Bivalirudin | Transradial
Makale Türü Özgün Makale
Makale Alt Türü SCOPUS dergilerinde yayımlanan tam makale
Dergi Adı EuroIntervention
Dergi ISSN 1774-024X
Makale Dili İngilizce
Basım Tarihi 10-2016
Cilt No 12
Sayı 9
Sayfalar 1154 / 1163
Doi Numarası 10.4244/EIJY15M12_01