Contrast agents used for excretory urography impair platelet function in human patients

Belleville, J; Freyria, Anne‐Marie; Pinet, A; Cornillon, Bernard; Paul, Jacqueline; Clendinnen, Guy; Eloy, R.

doi:10.1016/0049-3848(82)90169-4

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…Using epifluorescence videomicroscopy, he demonstrated that diatrizoate reduced platelet adhesion/aggregation more than did ioxaglate. However, a 1982 French study employing significantly lower RCM concentrations, showed ioxaglate to be the most consistent inhibitor of platelet aggregation, while diatrizoate appeared to promote platelet aggregation, though the increase was not staistically significant [5]. Shortly thereafter, two separate groups of investigators reported no effect of diatrizoate on platelet aggregation in vitro and ex vivo [7,12].…”

Section: Aggregation Kineticsmentioning

confidence: 93%

“…In two additional patients, the inhibition of aggregation ex vivo was still present 3 days after angiography. Subsequent studies [5,6] have suggested inhibition of aggregation appearing within 1 1/2 to 3 min. of RCM exposure, but whether the ex vivo effect is persistent [3,4] or more transient (returning to normal within 15 min [6], is controversial.…”

Section: Time Course Of Effectsmentioning

confidence: 96%

“…As shown in Table I [ 5 ] , or osmolarity [6,10]. That platelet ultrastructural changes and aggregate formation may occur during their exposure to RCM has been suggested [ 1,5].…”

Section: Platelet Size and Numbermentioning

confidence: 97%

“…Several investigators have noted a dichotomy in the effects of ionic and nonionic contrast media on platelet function [5,[9][10][11]261. One group was unable to demonstrate inhibition of platelet aggregation by sodium diatrizoate in vitro [ 121 and, in a retrospective review of 124 consecutive patients undergoing percutaneous transluminal coronary angioplasty (PTCA), Gasperetti and colleagues [ 191 reported that intracoronary thrombus formation was more common with nonionic than with ionic contrast media (p < 0.02).…”

Section: Ionic Vs Nonionic Contrast Agentsmentioning

confidence: 99%

“…Factors which may contribute to the effect of contrast agents on platelet function include; [Ca2'] [3,5], time of platelet/ RCM exposure [3-61, methylglucamine content, [7] chemical structure of the contrast agent [8] and osmolality [8,9]. Whether ionic and nonionic contrast agents [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Radiographic contrast agents and platelet function: A quenched‐flow study

Taylor

Angello

Ayers

et al. 1991

Cathet. Cardiovasc. Diagn.

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Radiographic contrast media (RCM) may alter platelet behavior at concentrations achieved during cardiac angiography. We used quenched-flow aggregometry coupled to single-particle counting to study the influence of RCM on the kinetics of platelet aggregation (less than 5.0 sec) induced by adenosine diphosphate (ADP, 2.86 microM). At a concentration in platelet-rich plasma (PRP) of 5 per cent RCM by volume, platelet aggregation was inhibited by diatrizoate, iopamidol and ioxaglate either directly or following incubation of each contrast agent with PRP for 20 minutes. Diatrizoate inhibited more than did iopamidol or ioxaglate (56 +/- 6, versus 39 +/- 3 and 40 +/- 9 per cent respectively; P less than 0.003, p less than 0.009, n = 20 normal subjects). A small reduction (about 16 per cent) in aggregation velocity occurred within 5 seconds of exposure of PRP to all 3 RCM and the onset time (t) or lag period before aggregation begins was significantly prolonged by diatrizoate (p less than 0.03). The RCM vehicles alone (iodinated moiety removed, osmolality readjusted) had no effect on the ADP-induced aggregation. Platelet counts fell significantly after incubation with diatrizoate (12%; p = 0.04). Our data therefore show that early platelet aggregation was inhibited by 3 commonly-used ionic and nonionic contrast agents. Inhibition was apparently caused by the iodinated contrast molecule, began within seconds of platelet-RCM contact and was independent of vehicle composition. Since diatrizoate inhibited aggregation more than iopamidol or ioxaglate, its use may be of additional value during angiographic procedures in clinical situations involving enhanced platelet activation.