***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background —Transradial percutaneous coronary intervention ( PCI [ TRI ] ) does not involve catheter manipulation in the descending aorta , whereas transfemoral PCI ( TFI ) does . Therefore , the risk of acute kidney injury ( AKI ) after PCI might be influenced by vascular access site . We compared risks of AKI and nephropathy requiring dialysis ( NRD ) among patients treated with TRI and TFI . Methods and Results —We included patients across 47 hospitals in Michigan . Primary end point was AKI ( serum creatinine increase ≥0.5 mg/dL ) . Secondary end points were NRD and postprocedural bleeding . Odds ratios ( OR ) for study end points were calculated for the entire and propensity-matched population , reported as crude , and values adjusted for preprocedural calculated AKI risk . Between 2010 and 2012 , a total of 82 225 PCI procedures were performed , of which 8915 were TRI . After adjustment , TRI was associated with a reduction in AKI ( OR , 0.76 , 95 % confidence intervals [ 0.62–0.92 ] ) and bleeding with a trend toward lower NRD risk . The propensity-matched population consisted of 8857 procedures per group . In this population , TRI was associated with lower adjusted odds of AKI ( OR , 0.74 ; 95 % confidence intervals [ 0.58–0.96 ] ) , and bleeding ( OR , 0.47 ; 95 % confidence intervals [ 0.36–0.63 ] ) , but no difference in NRD was observed . Although postprocedural bleeding was independently associated with AKI ( OR , 2.86 ; 95 % confidence intervals [ 1.75–4.66 ] ) in the propensity-matched population , the lower odds of AKI was not mediated by a reduction in  bleeding with TRI . Sensitivity analysis demonstrated that the observed association between access site and AKI could potentially be explained by a moderately strong unknown confounder . Conclusions —The risk of AKI was significantly lower after TRI compared with TFI . This finding needs to be evaluated in r and omized controlled trials Background : The safety and efficacy of a radial approach for percutaneous coronary intervention ( PCI ) in octogenarians is not well established . Methods : To evaluate the benefits of a radial approach for preventing vascular complications after PCI , clinical , procedural , and outcome data were prospect ively collected and compared for 228 octogenarians undergoing elective PCI either through a radial or a femoral approach .  Results : Radial approach was associated with longer cannulation ( 3.1 ± 2.9 vs. 2.0 ± 2.0 min , P < 0.001 ) and fluoroscopy times ( 19.3 ± 16.1 vs. 16.1 ± 11.8 min , P = 0.04 ) , greater utilization of contrast media ( 224 ± 46 vs. 182 ± 20 ml , P < 0.001 ) and higher crossover rate ( 11 vs 4 % , P = 0.03 ) to alternate access site compared with the femoral approach . However , ambulation time ( 5.2 ± 3.1 vs. 11.6 ± 6.3 hr , P < 0.001 ) , access site bleeding ( 4 vs. 14 % , P = 0.007 ) , hematoma ( 1 vs. 11 % , P = 0.001 ) or any vascular complication ( 5 vs 26 % , P = 0.001 ) were significantly reduced with a radial approach . Procedural success rates were equivalent with both approaches . Multivariate regression analysis identified radial approach ( OR = 0.23 ; CI = 0.08 , 0.65 ) as an independent negative predictor of postprocedural vascular complications . Conclusion : Radial approach for PCI in octogenarians is technically challenging for the operator and exposes patients to greater volume of nephrotoxic contrast media . However , it results in early ambulation and significantly reduces vascular complications in this high risk population . These findings support a strategy of preprocedural risk assessment and use of radial approach for PCI in a select group of octogenarians to maximize benefits offered by this technique . © 2006 Wiley‐Liss , CONTEXT Studies with positive results are more likely to be published than studies with negative results ( publication bias ) . One reason this occurs is that authors are less likely to su bmi t manuscripts reporting negative results to journals . There is no evidence that publication bias occurs once manuscripts have been su bmi tted to a medical journal . We assessed whether su bmi tted manuscripts that report results of controlled trials are more likely to be published if they report positive results . METHODS Prospect i ve cohort study of manuscripts su bmi tted to JAMA from February 1996 through August 1999 . We classified results as positive if there was a statistically significant difference ( P<.05 ) reported for the primary outcome . Study characteristics and indicators for quality were also appraised . We included manuscripts that reported prospect i ve studies in which participants were assigned to an intervention or comparison group and statistical tests compared differences between groups . RESULTS Among 745 manuscripts , 133 ( 17.9 % ) were published : 78 ( 20.4 % ) of 383 with positive results , 51 ( 15.0 % ) of 341 with negative results , and 4 ( 19.0 % ) of 21 with unclear results . The crude relative risk for publication of studies with positive results compared with negative results was 1.36 ( 95 % confidence interval [ CI ] , 0.99 - 1.88 ) . After being adjusted simultaneously for study characteristics and quality indicators , the odds ratio for publishing studies with positive results was 1.30 ( 95 % CI , 0.87 - 1.96 ) . CONCLUSIONS Among su bmi tted manuscripts , we did not find a statistically significant difference in publication rates between those with positive vs negative results OBJECTIVES This study investigated the effect of furosemide-forced diuresis and intravenous saline infusion matched with urine output , using a novel dedicated device design ed for contrast-induced nephropathy ( CIN ) prevention . BACKGROUND CIN is a frequent cause of acute kidney injury associated with increased morbidity and mortality . METHODS A total of 170 consecutive patients with chronic kidney disease ( CKD ) undergoing coronary procedures were r and omized to either furosemide with matched hydration ( FMH group , n = 87 ) or to st and ard intravenous isotonic saline hydration ( control group ; n = 83 ) . The FMH group received an initial 250-ml intravenous bolus of normal saline over 30 min followed by an intravenous bolus ( 0.5 mg/kg ) of furosemide . Hydration infusion rate was automatically adjusted to precisely replace the patient 's urine output . When a urine output rate > 300 ml/h was obtained , patients underwent the coronary procedure . Matched fluid replacement was maintained during the procedure and for 4 h post-treatment . The definition of CIN was a ≥25 % or ≥0.5 mg/dl rise in serum creatinine over baseline . RESULTS In the FMH group , no device- or therapy-related complications were observed . Four ( 4.6 % ) patients in the FMH group developed CIN versus 15 ( 18 % ) controls ( p = 0.005 ) . A lower incidence of cumulative in-hospital clinical complications was also observed in FMH-treated patients than in controls ( 8 % vs. 18 % ; p = 0.052 ) . CONCLUSIONS In patients with CKD undergoing coronary procedures , furosemide-induced high urine output with matched hydration significantly reduces the risk of CIN and may be associated with improved in-hospital outcome . ( Induced Diuresis With Matched Hydration Compared to St and ard Hydration for Contrast Induced Nephropathy Prevention [ MYTHOS ] ; NCT00702728 ) Acute kidney injury ( AKI ) is an important complication of both diagnostic cardiac catheterization and percutaneous coronary intervention ( PCI ) . A large body of evidence supports that AKI is related to volume of contrast used . Despite several measures are available to reduce the impact of contrast media on AKI , its incidence remains significant as other mechanisms of renal damage are involved . A new paradigm is established according to which bleeding prevention is at least as important as preventing recurrent ischemic events in the management of patients with acute coronary syndromes ( ACS ) undergoing an invasive approach .  Periprocedural bleeding , which is consistently reduced by radial approach , is emerging as a risk factor for the development of AKI . Therefore , the role of vascular access as a measure to prevent AKI needs to be systematic ally assessed in r and omized studies . To date , no prospect i ve comparison on renal outcomes has been carried out in r and omized trials between radial and femoral approach . The Minimizing Adverse hemorrhagic events by TRansradial access site and systemic Implementation of AngioX ( MATRIX ) trial ( Clinical Trials.gov identifier : NCT01433627 ) has been design ed to test whether to minimize bleeding events by using radial access and bivalirudin , across the whole spectrum of patients with ACS undergoing PCI  , will result in improved outcomes with respect to both ischemic and bleeding complications . The AKI‐MATRIX sub‐ study will provide a unique opportunity to assess whether the advantages of radial approach may even contribute to the reduction of the risk of AKI in patients with ACS . © 2015 Wiley Periodicals , OBJECTIVES This study sought to evaluate the association between contrast-induced acute kidney injury ( CI-AKI ) after percutaneous coronary intervention  and severity of bleeding estimated from periprocedural hemoglobin ( Hb ) measurement . BACKGROUND The relationship between CI-AKI and bleeding in contemporary practice remains controversial . METHODS In a retrospective analysis of the prospect ively maintained Japan Cardiovascular Data base-Keio Interhospital Cardiovascular Studies ( JCD-KICS ) multicenter registry , we divided 2,646 consecutive patients into 5 groups according to the change of Hb level after compared with before percutaneous coronary intervention : patients without a decrease in Hb level ( group A ) and patients with a decreased Hb level : < 1 g/dl ( group B ) ; 1 to < 2 g/dl ( group C ) ; 2 to < 3g/dl ( group D ) ; and > 3 g/dl ( group E ) . CI-AKI was defined as an increase in serum creatinine level ≥ 0.5 mg/dl or ≥ 25 % above baseline values at 48 h after administration of contrast media . Procedure and outcome variables were compared . RESULTS The mean patient age was 67 ± 11 years . Of the 2,646 patients  , CI-AKI developed in 315 ( 11.9 % ) . The CI-AKI incidence was 6.2 % , 7.5 % , 10.7 % , 17.0 % , and 26.2 % , in groups A through E , respectively ( p < 0.01 ) , whereas the incidence of major bleeding was 0.7 % , 1.3 % , 2.0 % , 4.1 % , and 28.3 % , respectively ( p < 0.01 ) . CI-AKI was associated with higher rates of mortality ( 5.4 % vs. 0.6 % , p < 0.01 ) and of composite of heart failure , cardiogenic shock , and death ( 16.5 % vs. 2.8 % , p < 0.01 ) . CONCLUSIONS Periprocedural bleeding was significantly associated with CI-AKI , with CI-AKI incidence correlating with bleeding severity BACKGROUND It is unclear whether radial compared with femoral access improves outcomes in unselected patients with acute coronary syndromes undergoing invasive management . METHODS We did a r and omised , multicentre , superiority trial comparing transradial against transfemoral access in patients with acute coronary syndrome with or without ST-segment elevation myocardial infa rct ion who were about to undergo coronary angiography and percutaneous coronary intervention . Patients were r and omly allocated ( 1:1 ) to radial or femoral access with a web-based system . The r and omisation sequence was computer generated , blocked , and stratified by use of ticagrelor or prasugrel , type of acute coronary syndrome ( ST-segment elevation myocardial infa rct ion , troponin positive or negative , non-ST-segment elevation acute coronary syndrome ) , and anticipated use of immediate percutaneous coronary intervention . Outcome assessors were masked to treatment allocation . The 30-day co primary outcomes were major adverse cardiovascular events , defined as death , myocardial infa rct ion , or stroke , and net adverse clinical events , defined as major adverse cardiovascular events or Bleeding Academic Research Consortium ( BARC ) major bleeding unrelated to coronary artery bypass graft surgery . The analysis was by intention to treat . The two-sided α was prespecified at 0·025 . The trial is registered at Clinical Trials.gov , number NCT01433627 . FINDINGS We r and omly assigned 8404 patients with acute coronary syndrome , with or without ST-segment elevation , to radial ( 4197 ) or femoral ( 4207 ) access for coronary angiography and percutaneous coronary intervention . 369 ( 
    Output:
    
Compared with the femoral approach , radial access was associated with a lower incidence of AKI after coronary angiography or intervention , although this benefit was less pronounced in multicenter than in single-center studies