Document Detail


Safety of contrast in stress echocardiography in stable patients and in patients with suspected acute coronary syndrome but negative 12-hour troponin.
MedLine Citation:
PMID:  19576314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Limited studies are available demonstrating the safety of contrast agents in patients undergoing stress echocardiography and none in patients with suspected acute coronary syndrome (ACS). Therefore, we sought to assess the safety profile of contrast agents in patients with stable chest pain and in those with suspected ACS (nondiagnostic electrocardiogram and negative initial 12-hour cardiac troponin test results). During a 4-year period, 3,704 patients underwent stress echocardiography (exercise or dobutamine), of whom, 929 (25%) had suspected ACS. Contrast agents (SonoVue 46%, Luminity 54%) were used in 1,150 patients (31%). No patients died with or without contrast administration. No nonfatal acute myocardial infarction occurred in patients administered contrast agents compared with 3 cases of acute myocardial infarction in the noncontrast group (p = 0.24). Two cases of sustained ventricular tachycardia developed, one in each group (p = 0.98). Compared with those who did not receive contrast, patients in both the stable chest pain and the suspected ACS groups had a greater burden of cardiovascular risk factors. The left ventricular function at rest was significantly worse in the patients who received contrast than in those who did not in the suspected ACS group. Also, a greater ischemic burden was present in those receiving contrast than in those not receiving it in both the stable chest pain and the suspected ACS groups. In conclusion, despite the presence of greater risk features compared with patients undergoing unenhanced stress echocardiography, the administration of ultrasound contrast agents (SonoVue and Luminity) in those with stable chest pain and those with suspected ACS was not associated with excess adverse events.
Authors:
Brijesh Anantharam; Navtej Chahal; Rajesh Chelliah; Ihab Ramzy; Firoz Gani; Roxy Senior
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Publication Detail:
Type:  Journal Article     Date:  2009-04-16
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  14-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology and Institute of Postgraduate Medical Education and Research, Northwick Park Hospital, Harrow, UK.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / blood,  physiopathology,  ultrasonography*
Aged
Chest Pain
Contrast Media / adverse effects*
Echocardiography, Stress*
Female
Hemodynamics
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Factors
Troponin / blood*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Troponin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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