| A comparison of ionic versus nonionic contrast medium during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (GUSTO IIb). Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes. | |
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MedLine Citation:
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PMID: 12000041 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The clinical impact of contrast medium selection during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (AMI) has not been studied. We compared the clinical outcomes of patients who received ionic versus nonionic low osmolar contrast medium in the setting of primary percutaneous transluminal coronary angioplasty for AMI in the second Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) trial. Univariable and multivariable analyses were performed to assess the relation between contrast medium selection and clinical outcome (death, reinfarction, or refractory ischemia) at 30 days. Although baseline clinical and angiographic characteristics were generally similar between the 2 groups, patients who received ionic, low osmolar contrast were less likely to have been enrolled at a US site (23% vs 43%, p = 0.001) and less likely to have occlusion of the left anterior descending coronary artery (34% vs 47%, p = 0.03) or a history of prior AMI (8% vs 16%, p = 0.02). The triple composite end point of death, reinfarction, or refractory ischemia occurred less frequently in the ionic group, both in the hospital (4.4% vs 11%, p = 0.018) and at 30 days (5.5% vs 11%, p = 0.044). Although the trend favoring ionic contrast persisted, the differences were no longer statistically significant after adjustment for imbalances in baseline characteristics using a risk model developed from the study sample (n = 454, adjusted odds ratio for ionic contrast 0.48 [0.22 to 1.02], p = 0.055), and using a model developed from the entire GUSTO IIb study cohort (n = 12,142, adjusted odds ratio for ionic contrast 0.50 [0.23 to 1.06], p = 0.072). The results of this observational study warrant further elucidation by a randomized study design in this setting. |
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Authors:
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W B Batchelor; C B Granger; N S Kleiman; H R Phillips; S G Ellis; A Betriu; D A Criger; A L Stebbins; E J Topol; R M Califf; |
Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 85 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2000 Mar |
Date Detail:
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Created Date: 2002-05-09 Completed Date: 2002-05-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 692-7 Citation Subset: AIM; IM |
Affiliation:
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Terrence Donnelly Heart Centre, Division of Cardiology, St Michael's Hospital, University of Toronto, Ontario, Canada. batchelorw@smh.toronto.on.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary Contrast Media* Coronary Angiography Female Humans Iohexol / diagnostic use Iopamidol / diagnostic use Ioxaglic Acid / diagnostic use Male Middle Aged Myocardial Infarction / radiography, therapy* Osmolar Concentration Retrospective Studies Risk Factors Treatment Outcome Triiodobenzoic Acids / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Triiodobenzoic Acids; 59017-64-0/Ioxaglic Acid; 62883-00-5/Iopamidol; 66108-95-0/Iohexol; 87771-40-2/ioversol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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