THE POTENTIAL THROMBOGENIC ACTION OF A NONIONIC RADIOGRAPHIC CONTRAST-MEDIUM USED DURING CORONARY ANGIOGRAPHY IS OFFSET BY HEPARIN DURING CORONARY ANGIOPLASTY

Iohexol sodium, a nonionic radiographic contrast medium, used in invas ive imaging techniques has been shown to be potentially thrombogenic. In the present study, the effect of iohexol sodium on haemostatic fact ors was evaluated in 20 patients, 16 male and 4 female, 10 undergoing coronary angiography and another IO undergoing coronary angioplasty. A ll the patients had angiographically-assessed coronary artery disease. The patients undergoing coronary angioplasty received a significantly larger quantity of the dye as compared with the patients undergoing c oronary angiography. The former group of patients also received a bolu s of 20,000 units of standard heparin in addition. The levels of throm bin-antithrombin-III complex (TAT), prothrombin fragments 1 and 2 (F1F 2), D-dimer and the functional activity of tissue factor pathway inhib itor (TFPI) were assayed. While the baseline and 30-min post-dye level s of TAT and F1F2 were comparable in patients undergoing coronary angi oplasty, the 30 min levels were significantly elevated in patients und ergoing coronary angiography. The post-dye levels of TFPI activity wer e significantly increased in the former group due to the heparin-induc ed release of TFPI. It is concluded that the thrombogenic potential of iohexol sodium was overcome by heparin used routinely during coronary angioplasty.