Influence of a nonionic, iso-osmolar contrast medium (iodixanol) versus anionic, low-osmolar contrast medium (ioxaglate) on major adverse cardiac events in patients undergoing percutaneous transluminal coronary angioplasty a multicenter, randomized, double-blind study
Me. Bertrand et al., Influence of a nonionic, iso-osmolar contrast medium (iodixanol) versus anionic, low-osmolar contrast medium (ioxaglate) on major adverse cardiac events in patients undergoing percutaneous transluminal coronary angioplasty a multicenter, randomized, double-blind study, CIRCULATION, 101(2), 2000, pp. 131-136
Citations number
31
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background-The potential merits and disadvantages of the use of ionic or no
nionic contrast media in patients undergoing percutaneous transluminal coro
nary angioplasty (PTCA) have been the subjects of controversy. The present
study was designed to evaluate the possible influence of both types of cont
rast media on major adverse cardiac events (MACE) in patients undergoing PT
CA.
Methods and Results-In a randomized, parallel-group, double-blind study, 14
11 patients received either iodixanol (a nonionic, iso-osmolar contrast med
ium) or ioxaglate (an ionic, low-osmolar contrast medium) during PTCA. A st
andardized anticoagulation regimen was followed. Patients were monitored in
the hospital for 2 days and followed-up at 1 month. The primary end point,
a composite of MACE (death, stroke, myocardial infarction, coronary artery
bypass grafting, and re-PTCA) after 2 days, occurred in 4.3% of the total
population, with no statistically significant difference between groups (io
dixanol, 4.7%; ioxaglate, 3.9%; P=0.45). Further, between 2-day and 1-month
follow-ups, no significant difference (P=0.27) existed between the groups
in the rates of MACE. Hypersensitivity reactions (P=0.007) and adverse drug
reactions (P=0.002) were significantly less frequent in the iodixanol grou
p. The only significant predicting factors for the occurrence of MACE were
dissection/abrupt closure and country.
Conclusions-No significant differences were observed between the iodixanol
and ioxaglate groups with regard to MACE, although hypersensitivity and adv
erse drug reactions were significantly less frequent in patients who receiv
ed iodixanol.