Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2018 Jan 8;11(1):36-50.
doi: 10.1016/j.jcin.2017.09.014.

Impact of Sex on Comparative Outcomes of Radial Versus Femoral Access in Patients With Acute Coronary Syndromes Undergoing Invasive Management: Data From the Randomized MATRIX-Access Trial

Giuseppe Gargiulo  1 , Sara Ariotti  2 , Pascal Vranckx  3 , Sergio Leonardi  4 , Enrico Frigoli  2 , Nestor Ciociano  5 , Carlo Tumscitz  6 , Francesco Tomassini  7 , Paolo Calabrò  8 , Stefano Garducci  9 , Gabriele Crimi  10 , Giuseppe Andò  11 , Maurizio Ferrario  4 , Ugo Limbruno  12 , Bernardo Cortese  13 , Paolo Sganzerla  14 , Alessandro Lupi  15 , Filippo Russo  16 , Roberto Garbo  17 , Arturo Ausiello  18 , Dennis Zavalloni  19 , Gennaro Sardella  20 , Giovanni Esposito  21 , Andrea Santarelli  22 , Simone Tresoldi  23 , Marco Stefano Nazzaro  24 , Antonio Zingarelli  25 , Anna Sonia Petronio  26 , Stephan Windecker  2 , Bruno R da Costa  27 , Marco Valgimigli  28
Affiliations
Free article
Clinical Trial

Impact of Sex on Comparative Outcomes of Radial Versus Femoral Access in Patients With Acute Coronary Syndromes Undergoing Invasive Management: Data From the Randomized MATRIX-Access Trial

Giuseppe Gargiulo et al. JACC Cardiovasc Interv. .
Free article

Abstract

Objectives: This study sought to assess whether transradial access (TRA) compared with transfemoral access (TFA) is associated with consistent outcomes in male and female patients with acute coronary syndrome undergoing invasive management.

Background: There are limited and contrasting data about sex disparities for the safety and efficacy of TRA versus TFA for coronary intervention.

Methods: In the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) program, 8,404 patients were randomized to TRA or TFA. The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), defined as death, myocardial infarction, or stroke, and net adverse clinical events (NACE), defined as MACCE or major bleeding.

Results: Among 8,404 patients, 2,232 (26.6%) were women and 6,172 (73.4%) were men. MACCE and NACE were not significantly different between men and women after adjustment, but women had higher risk of access site bleeding (male vs. female rate ratio [RR]: 0.64; p = 0.0016), severe bleeding (RR: 0.17; p = 0.0012), and transfusion (RR: 0.56; p = 0.0089). When comparing radial versus femoral, there was no significant interaction for MACCE and NACE stratified by sex (pint = 0.15 and 0.18, respectively), although for both coprimary endpoints the benefit with TRA was relatively greater in women (RR: 0.73; p = 0.019; and RR: 0.73; p = 0.012, respectively). Similarly, there was no significant interaction between male and female patients for the individual endpoints of all-cause death (pint = 0.79), myocardial infarction (pint = 0.25), stroke (pint = 0.18), and Bleeding Academic Research Consortium type 3 or 5 (pint = 0.45).

Conclusions: Women showed a higher risk of severe bleeding and access site complications, and radial access was an effective method to reduce these complications as well as composite ischemic and ischemic or bleeding endpoints.

Trial registration: ClinicalTrials.gov NCT01433627.

Keywords: MATRIX; acute coronary syndrome(s); female; femoral access; male; radial access.

PubMed Disclaimer

Comment in

MeSH terms

Associated data

LinkOut - more resources