Prevention of radial artery occlusion with rivaroxaban after trans-radial access coronary procedures: The RIVARAD multicentric randomized trial.

Autor:	Hammami R; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia.; University of Sfax, Sfax, Tunisia.; Faculty of Medicine, University of Sfax, Sfax, Tunisia., Abid S; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia., Jihen J; University of Sfax, Sfax, Tunisia.; Faculty of Medicine, University of Sfax, Sfax, Tunisia.; Epidemiology Department, Hedi Chaker Hospital, Sfax, Tunisia., Triki Z; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia., Ben Mrad I; Habib Hospital Thameur, Tunis, Tunisia., Kammoun A; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia.; University of Sfax, Sfax, Tunisia.; Faculty of Medicine, University of Sfax, Sfax, Tunisia., Slim M; Hôpital Sahloul, Sousse, Tunisia., Kacem M; Hôpital Sahloul, Sousse, Tunisia., Thabet H; Hôpital Sahloul, Sousse, Tunisia., Abdessalem AB; Centre Hôpital Universitaire Farhat Hached, Sousse, Tunisia., Mallek S; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia., Charfeddine S; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia.; University of Sfax, Sfax, Tunisia.; Faculty of Medicine, University of Sfax, Sfax, Tunisia., Triki F; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia.; University of Sfax, Sfax, Tunisia.; Faculty of Medicine, University of Sfax, Sfax, Tunisia., Hejri SE; Centre Hôpital Universitaire Farhat Hached, Sousse, Tunisia., Naffeti I; Hôpital Sahloul, Sousse, Tunisia., Denguir H; Gabes University, Gabès, Tunisia., Kraeim S; Habib Hospital Thameur, Tunis, Tunisia., Abid L; Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia.; University of Sfax, Sfax, Tunisia.; Faculty of Medicine, University of Sfax, Sfax, Tunisia.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2023 Apr 21; Vol. 10, pp. 1160459. Date of Electronic Publication: 2023 Apr 21 (Print Publication: 2023).
DOI:	10.3389/fcvm.2023.1160459
Abstrakt:	Background: Radial artery occlusion (RAO) remains the most frequent complication of trans-radial access. Once the radial artery is occluded, its future use as an access site for coronary procedures, or as a conduit for coronary bypass grafting or fistula for hemodialysis, will be precluded. Therefore, we aimed to assess the value of the short-term use of Rivaroxaban to prevent RAO after a trans-radial coronary procedure. Methods: This was a prospective, open-label, randomized study. The patients were randomly assigned (1:1) to one of two groups: those who received Rivaroxaban 10 mg for 7 days following the trans-radial coronary procedure (the Rivaroxaban Group) and those who received the standard treatment (the Control Group). The primary outcome was an occurrence of RAO evaluated by Doppler ultrasound at 30 days, and the secondary outcomes were hemorrhagic complications according to BARC classification. Results: We included 521 patients randomized into two Groups: the Control Group ( N  = 262) and the Rivaroxaban Group ( N  = 259). The 1-month RAO was significantly reduced in the Rivaroxaban Group as compared to the Control Group [6.9% vs. 13%; p  = 0.011, OR = 0.5, (95% CI, 0.27-0.91)]. We noted no cases of severe bleeding events (BARC3-5). The overall incidence of minor bleeding (BARC1) was 2.3%, with no significant difference between the two groups [Rivaroxaban Group = 2.7%, Control Group = 1.9%, p  = 0.54, OR= 1.4, (95%CI 0.44-4.5)]. Conclusions: Short-term postoperative anticoagulation with Rivaroxaban 10 mg for seven days reduces the rate of 1-month RAO. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Hammami, Abid, Jihen, Triki, Ben Mrad, Kammoun, Slim, kacem, Thabet, Abdessalem, Mallek, Charfeddine, Triki, Hejri, Naffeti, Denguir, Kraeim and Abid.)
Databáze:	MEDLINE
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