TAT, F1-DIMER LEVELS IN PATIENTS AFTER CORONARY ANGIOGRAPHY WITH NONIONIC OR IONIC CONTRAST-MEDIA OR AFTER CARDIAC-CATHETERIZATION(2, AND D)

The prothrombotic effects of nonionic contrast media (NICM) have been evaluated in both biological and clinical studies. The question of whe ther there is a higher risk of thromboembolism during angiography with NICM than with ionic contrast media (ICM) has not yet been answered, nor has the precise role of the angiographic procedure per se in such complications been determined. The present study was performed to comp are in vivo the potential prothrombotic effects during cardiac angiogr aphy of an NICM with those of an ICM, to estimate the effects of the p rocedure per se, and to assess how long these effects might be maintai ned. We measured blood levels of three markers of activation of blood coagulation: thrombin-antithrombin III (TAT) complexes, prothrombin fr agment 1+2 (F1+2), and the split product of fibrin, D-dimer, before an d after coronary angiography in three groups of patients. In group 1, 14 patients underwent coronary angiography with the NICM iopamidol 370 . In group 2, 10 patients underwent coronary angiography with the ICM ioxaglate. In group 3, 10 patients were evaluated immediately after ca rdiac catheterization, before the injection of contrast material, as c ontrols. No statistically significant differences between the three gr oups were found in TAT, F1+2, or D-dimer levels at different times bef ore and after coronary angiography. There was a trend toward a transie nt increase in TAT levels after coronary angiography with iopamidol, w hich at first suggested a possible brief activation of hemostasis with this NICM, but a similar trend was also seen in the control group. We hypothesize that not only the type of contrast material, but also the angiographic procedure per se and patient-related factors all play ro les in determining a prothrombotic state during coronary angiography.