Nonionic low-osmolar contrast media have no impact on major adverse cardiac events in patients undergoing coronary stenting with appropriate antiplatelet therapy.

Abstract

The aim of this study was to assess the impact of two nonionic low-osmolar monomers (iopamidol and iopromide) and one ionic low-osmolar dimeric contrast medium (ioxaglate) on 30-day major adverse cardiac events in patients undergoing coronary interventions involving the use of new-generation stents and appropriate antiplatelet agents. Thirteen hundred and eight patients treated with stent implantation were randomized to receive ioxaglate (438 patients), iopamidol (442 patients), or iopromide (428 patients). Most of them (55%) had an acute coronary syndrome. Glycoprotein IIb/IIIa inhibitors were used in 37% of cases. All of the patients were on aspirin and ticlopidine for 1 month after the procedure. There was no significant between-group difference in the incidence of the primary composite endpoint of major adverse cardiac events 30 days after stenting (ioxaglate 3.6%; iopamidol 2.3%; iopromide 4.2%; P = 0.27). Adverse drug reactions were more frequent in the ioxaglate group (4.6% vs. 1.1% vs. 0.5%; P = 0.001). Multivariate analysis showed that intracoronary thrombus (P = 0.002), diabetes mellitus (P = 0.01), and postprocedure minimum lumen diameter (P = 0.04) independently correlated with an adverse outcome after 1 month. In conclusion, no significant differences in 30-day major ischemic complications were observed in this unselected population of patients undergoing coronary stenting who received ioxaglate, iopamidol, or iopromide. These data seem to suggest that the use of nonionic low-osmolar contrast media does not adversely affect stent patency.

• Authors: Gian B Danzi, Cinzia Capuano, Marco Sesana, Simonetta Predolini, Roberto Baglini
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 60 Issue 4 Pg. 477-82 (Dec 2003) ISSN: 1522-1946 [Print] United States
• PMID: 14624424 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2003 Wiley-Liss, Inc.

Chemical References

• Contrast Media
• Platelet Aggregation Inhibitors
• Iohexol
• iopromide
• Iopamidol
• Ioxaglic Acid

Topics

• Analysis of Variance
• Angioplasty, Balloon, Coronary
• Chi-Square Distribution
• Contrast Media (adverse effects)
• Coronary Angiography
• Coronary Disease (therapy)
• Drug Hypersensitivity (epidemiology)
• Female
• Humans
• Iohexol (adverse effects, analogs & derivatives)
• Iopamidol (adverse effects)
• Ioxaglic Acid (adverse effects)
• Male
• Middle Aged
• Osmolar Concentration
• Platelet Aggregation Inhibitors (therapeutic use)
• Stents