Comparison of ionic and nonionic low osmolar contrast media in relation to thrombotic complications of angioplasty in patients with unstable angina
| Autor: | Serge Doucet, Diane Duval, Gilbert Gosselin, Jacques Lespérance, Jean Laurier, Gilles Hudon, Mehrdad Malekianpour, Raoul Bonan |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Ioxaglic acid Contrast Media Coronary Angiography Iopamidol Angina Coronary thrombosis Internal medicine Angioplasty Ioxaglic Acid medicine Humans Angina Unstable Angioplasty Balloon Coronary Thrombus Aged Aged 80 and over Unstable angina business.industry Coronary Thrombosis Osmolar Concentration Middle Aged medicine.disease Thrombosis Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | American Heart Journal. 135:1067-1075 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/s0002-8703(98)70074-2 |
| Popis: | Background: Acute complications of percutaneous transluminal coronary angioplasty (PTCA) are more common in patients with unstable coronary syndromes. The objective of this study was to prospectively determine the differences between ionic and nonionic low osmolar contrast media (LOCM) on potential risk of acute complications, particularly abrupt vessel closure, in patients with unstable angina undergoing PTCA. Methods: A total of 210 patients with 278 lesions were randomized to receive either ionic or nonionic LOCM during PTCA. Quantitative coronary angiographic measurements and assessment of filling defects were made by experienced observers who were blinded to the type of contrast media used. Results: The baseline clinical and angiographic characteristics, the immediate postangioplasty results, and clinical outcome were similar in both groups. Subacute recoil, defined as the difference between minimal luminal diameter (in millimeters) at 0 and 15 minutes after angioplasty, was significantly greater in patients receiving nonionic LOCM (0.17 ± 0.36 mm vs 0.07 ± 0.18 mm, p = 0.004). A filling defect abnormality attributable to dissection, thrombus, or a combination of the two was noted in similar proportions of the two groups. Although nonsignificant, more thrombus was noted in the nonionic group (21 of 129 vs 15 of 141, p = NS). The abrupt vessel closure rate was similar in the two groups and was only 1.9% in the first 24 hours. However, 17 (8.3%) patients had a repeat PTCA at 15 minutes (9 ionic vs 8 nonionic). Conclusion: In patients with unstable angina the choice of ionic or nonionic LOCM does not appear to significantly affect the clinical outcome of PTCA. (Am Heart J 1998;135:1067-75.) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect