• Arie Steinvil, Hector M Garcia-Garcia, Toby Rogers, Eddie Koifman, Kyle Buchanan, M Chadi Alraies, Rebecca Torguson, Augusto D Pichard, Lowell F Satler, Itsik Ben-Dor, and Ron Waksman.
• Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
• Am. J. Cardiol. 2017 May 15; 119 (10): 1507-1511.

AbstractTransradial percutaneous coronary intervention (TR-PCI) may be associated with reduced rates of acute kidney injury (AKI). There is limited data from real-world registries about AKI rates stratified by PCI access. Our aim was to evaluate AKI rates and correlates in TR-PCI versus transfemoral PCI (TF-PCI) in a propensity score-matched analysis of patient data from a large, single-center registry. We performed a 1:1 propensity score-matched analysis on consecutive patients who underwent PCI from January 2011 to June 2016, excluding those on dialysis. A multivariate logistic regression model was adjusted to variables found to be significant in univariate models. AKI was defined by creatinine increase of ≥0.3 mg/dL post-PCI during hospitalization. During the study period, 6,743 patients underwent PCI (TR-PCI n = 1,119). Initial univariate models revealed significant differences between patients with TF-PCI and TR-PCI. Contrast amount and procedure duration were both increased with TR-PCI versus TF-PCI (162 vs 154 ml, p = 0.003; and 86 vs 79 minutes, p <0.001, respectively). Multivariate propensity score analysis matched 536 pairs of patients. In this matched cohort, TR-PCI was associated with a reduced risk for AKI compared with TF-PCI in univariate (4.3% vs 10.4%, p <0.001) and multivariate adjusted models (odds ratio 0.28, 95% confidence interval 0.19 to 0.59, p <0.001).Copyright © 2017 Elsevier Inc. All rights reserved.

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