A meta-analysis of the risk of total cardiovascular events of isosmolar iodixanol compared with low-osmolar contrast media

Zhang, Bu-Chun; Wu, Qiang; Wang, Cheng; Li, Dongye; Wang, Zhirong

doi:10.1016/j.jjcc.2013.11.021

Cited by 11 publications

(7 citation statements)

References 27 publications

(36 reference statements)

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“…Our findings that iodixanol may be associated with a lower occurrence of cardiovascular adverse events seem to contradict another meta-analysis performed by Zhang et al, [39] which shows no significant reduction in cardiovascular events with iodixanol when compared with LOCM overall in all patients. However, it should be noted that in that analysis, 7 of 13 were trials comparing iodixanol with ioxaglate.…”

Section: Discussioncontrasting

confidence: 99%

Iodixanol versus iopromide in patients with renal insufficiency undergoing coronary angiography with or without PCI

Zhang

Jiang

et al. 2018

Medicine

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Section: Discussioncontrasting

confidence: 99%

Iodixanol versus iopromide in patients with renal insufficiency undergoing coronary angiography with or without PCI

Zhang

Jiang

et al. 2018

Medicine

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“…more and more prospective randomized trials and systemic reviews have proven that there are no significant differences in nephrotoxicity between IOCM and LOCM (Solomon, 2005;Shin et al, 2011;Bolognese et al, 2012;Lameire et al, 2013Lameire et al, , 2014Zhang et al, 2014). In light of this information, many work groups have failed to recommend a preference for either type of agent (Lameire et al, 2013;Solomon, 2014), suggesting that explanations for the toxicity of CM other than osmolality should be explored in relation to the pathogenesis of CI-AKI.…”

Section: Discussionmentioning

confidence: 99%

Valsartan protects HK‐2 cells from contrast media‐induced apoptosis by inhibiting endoplasmic reticulum stress

Peng

Wang

et al. 2015

Cell Biology International

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Contrast-induced acute kidney injury (CI-AKI) is associated with increasing in-hospital and long-term adverse clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI). Contrast media (CM)-induced renal tubular cell apoptosis is reported to participate in this process by activating endoplasmic reticulum (ER) stress. An angiotensin II type 1 receptor (AT1R) antagonist can alleviate ER stress-induced renal apoptosis in streptozotocin (STZ)-induced diabetic mice and can reduce CM-induced renal apoptosis by reducing oxidative stress and reversing the enhancement of bax mRNA and the reduction of bcl-2 mRNA, but the effect of the AT1R blocker on ER stress in the pathogenesis of CI-AKI is still unknown. In this study, we explored the effect of valsartan on meglumine diatrizoate-induced human renal tubular cell apoptosis by measuring changes in ER stress-related biomarkers. The results showed that meglumine diatrizoate caused significant cell apoptosis by up-regulating the expression of ER stress markers, including glucose-regulated protein 78 (GRP78), activating transcription factor 4 (ATF4), CCAAT/enhancer-binding protein-homologous protein (CHOP) and caspase 12, in a time- and dose-dependent manner, which could be alleviated by preincubation with valsartan. In conclusion, valsartan had a potential nephroprotective effect on meglumine diatrizoate-induced renal cell apoptosis by inhibiting ER stress.

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“…Adverse event rates associated with LOCMs have been studied extensively and while this study shows no difference in the rate of the MARCE composite, results of prior published studies have varied. Meta‐analyses of available RCTs have been published comparing LOCMs and IOCMs, the overlap in time‐periods and inclusion criteria led to the use of some of the same trials in multiple studies.…”

Section: Discussionmentioning

confidence: 64%

“…There are a considerable number of reports evaluating the safety of contrast media, though the study methods and findings are variable . There are several meta‐analyses of randomized controlled trials (RCT), comparing CI‐AKI rates between LOCMs and iso‐osmolar CM (IOCMs) .…”

Section: Introductionmentioning

confidence: 99%

Rate of major adverse renal or cardiac events with iohexol compared to other low osmolar contrast media during interventional cardiovascular procedures

McCullough

Todoran

Brilakis

et al. 2018

Cathet Cardio Intervent

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Objective This study assessed the rate of major adverse renal or cardiac events (MARCE) when iohexol is used during interventional cardiovascular procedures compared to other low osmolar contrast media (LOCMs). Background Interventional cardiovascular procedures are often essential for diagnosis and treatment, the risk of MARCE should be considered. Methods Data were derived from the Premier Hospital Database January 1, 2010 through September 30, 2015. Patient encounters with an inpatient primary interventional cardiovascular procedure with a single LOCM (iohexol, ioversol, ioxilan, ioxaglate, or iopamidol) were included. The primary outcome was a composite endpoint of MARCE, which included: renal failure with dialysis, acute kidney injury (AKI) with or without dialysis, contrast induced AKI, acute myocardial infarction, angina, stent occlusion/thrombosis, stroke, transient ischemic attack, or death. Multivariable regression analysis was performed using the hospital fixed‐effects specification to assess the relationship between MARCE and iohexol compared to other LOCMs, while controlling for patient demographics, comorbid conditions and reason for hospitalization. As a sensitivity analysis, direct comparisons of iohexol were made to other LOCMs. Results A total of 458,091 inpatient encounters met inclusion criteria of which 26% used iohexol and 74% used other LOCMs. Results of multivariable modeling revealed no differences in MARCE rates between iohexol and other LOCMs. When direct comparisons of iohexol vs. ioversol and iopamidol were modeled, no differences in MARCE nor the renal component of MARCE were found. Conclusions In this retrospective multicenter study, there were no differences in MARCE events with iohexol compared to other LOCMs during inpatient interventional cardiovascular procedures.

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A meta-analysis of the risk of total cardiovascular events of isosmolar iodixanol compared with low-osmolar contrast media

Abstract: This meta-analysis demonstrates that there is no conclusive evidence that iodixanol is superior to LOCM overall with regard to fewer cardiovascular events.

Cited by 11 publications

References 27 publications

Iodixanol versus iopromide in patients with renal insufficiency undergoing coronary angiography with or without PCI

Iodixanol versus iopromide in patients with renal insufficiency undergoing coronary angiography with or without PCI

Valsartan protects HK‐2 cells from contrast media‐induced apoptosis by inhibiting endoplasmic reticulum stress

Rate of major adverse renal or cardiac events with iohexol compared to other low osmolar contrast media during interventional cardiovascular procedures

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