Document Detail


Functional contrast-enhanced CT for evaluation of acute ischemic stroke does not increase the risk of contrast-induced nephropathy.
MedLine Citation:
PMID:  20044502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a >or=25% increase in the post-contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration.
MATERIALS AND METHODS: The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA (n = 313), CTA/CTP (n = 224), or CTA/CTP followed by conventional angiography (n = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only.
RESULTS: The incidence of AN was 5% in the exposed and 10% in the nonexposed group (P = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; P = .7).
CONCLUSIONS: Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN.
Authors:
F O Lima; M H Lev; R A Levy; G S Silva; M Ebril; E C de Camargo; S Pomerantz; A B Singhal; D M Greer; H Ay; R Gilberto González; W J Koroshetz; W S Smith; K L Furie
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2009-12-31
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-14     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  817-21     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Brain Ischemia / epidemiology*,  radiography*
Comorbidity
Drug-Related Side Effects and Adverse Reactions / epidemiology
Female
Humans
Incidence
Iodine / diagnostic use*
Kidney Diseases / epidemiology*
Male
Massachusetts / epidemiology
Risk Assessment
Risk Factors
Stroke / epidemiology*,  radiography*
Tomography, X-Ray Computed / statistics & numerical data*
Grant Support
ID/Acronym/Agency:
1-R01-NS059710-01A2/NS/NINDS NIH HHS; P50 NS051343/NS/NINDS NIH HHS; R01 HS011392/HS/AHRQ HHS; R01 NS059710/NS/NINDS NIH HHS; R01 NS059710-01A2/NS/NINDS NIH HHS; R01-NS051412/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
9679TC07X4/Iodine
Comments/Corrections

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