Document Detail


A randomized trial comparing the impact of a nonionic (Iomeprol) versus an ionic (Ioxaglate) low osmolar contrast medium on abrupt vessel closure and ischemic complications after coronary angioplasty.
MedLine Citation:
PMID:  9973019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the effect of nonionic versus ionic contrast media on abrupt vessel closure and major ischemic complications after coronary angioplasty. BACKGROUND: There is a continuous debate about the "thrombogenic potential" of nonionic contrast media. The results of both in vitro and in vivo investigations are incongruent. METHODS: We prospectively evaluated the outcomes of 2,000 patients undergoing percutaneous transluminal coronary angioplasty (PTCA). According to a randomized, double-blind protocol, they received either iomeprol (nonionic; n = 1,001) or ioxaglate (ionic; n = 999). Intracoronary thrombus before PTCA was found more often in the iomeprol group (4.2% vs 2.7%, p = 0.04). No other significant differences between both groups were observed with regard to pre-PTCA clinical and angiographic characteristics. RESULTS: The frequency of reocclusions necessitating repeat angioplasty occurring either in laboratory (2.9% with iomeprol and 3.0% with ioxaglate) or out of laboratory (3.1% vs 4.1%) was not significantly different. The rate of major ischemic complications was also comparable after both contrast media (emergency bypass surgery: 0.8% vs 0.7%, myocardial infarction: 1.8 vs 2.0%, cardiac death during hospital stay: 0.2% vs 0.2%). In the iomeprol group, more patients had dissections post-PTCA (30.2% vs 25.0%, p = 0.01) and more patients received intracoronary stents (31.6% vs 25.7%, p = 0.004). Allergic reactions requiring treatment occurred only in the ioxaglate group (0.0% vs 0.9%, p = 0.002). CONCLUSIONS: The nonionic contrast medium was not associated with a higher rate of abrupt vessel closure requiring repeat angioplasty, or major ischemic events. These data suggest that nonionic contrast media do not increase the risk of thrombotic complications in patients undergoing coronary interventions.
Authors:
R Schräder; I Esch; R Ensslen; W A Fach; H Merle; D Scherer; H Sievert; H F Spies; H E Zeplin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  33     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-03-02     Completed Date:  1999-03-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  395-402     Citation Subset:  AIM; IM    
Affiliation:
Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  instrumentation
Contrast Media / adverse effects*
Coronary Angiography / adverse effects
Coronary Thrombosis / chemically induced*,  radiography,  surgery
Double-Blind Method
Female
Follow-Up Studies
Humans
Iopamidol / adverse effects,  analogs & derivatives*
Ioxaglic Acid / adverse effects*
Male
Middle Aged
Myocardial Ischemia / radiography,  surgery
Prospective Studies
Reoperation
Stents
Chemical
Reg. No./Substance:
0/Contrast Media; 59017-64-0/Ioxaglic Acid; 62883-00-5/Iopamidol; 78649-41-9/iomeprol

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


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