Iodixanol in Cardioangiography in Patients with Coronary Artery Disease

Kløw, Nils‐Einar; Levorstad, K.; Berg, K. J.; Brodahl, U.; Endresen, Knut; Kristoffersen, Doris Tove; Laake, B.; Simonsen, Svein; Tofte, A. J.; Lundby, B.

doi:10.1080/02841859309173240

Cited by 32 publications

(10 citation statements)

References 18 publications

(3 reference statements)

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“…Pain frequencies in our study are higher than those already published for iomeprol, but the frequencies are not directly comparable due to differences in study design (open study including different concentrations of iomeprol) and use of lower iodine concentration (150 mgI/ml), thus with lower osmolality for iomeprol (16, 19). Previously published results show that iodixanol causes less injection‐associated pain and severe heat sensation than LOCM for other intra‐arterial administration sites as well, e.g., cerebral arteriography and cardioangiography (9, 11, 14).…”

Section: Discussionmentioning

confidence: 99%

Pain in Femoral Arteriography. A double-blind, randomized, clinical study comparing safety and efficacy of the iso-osmolar iodixanol 270 mgI/ml and the low-osmolar iomeprol 300 mgI/ml in 9 European centers

Manke¹,

Marcus²,

Page³

et al. 2003

Acta Radiologica

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Section: Discussionmentioning

confidence: 99%

Pain in Femoral Arteriography. A double-blind, randomized, clinical study comparing safety and efficacy of the iso-osmolar iodixanol 270 mgI/ml and the low-osmolar iomeprol 300 mgI/ml in 9 European centers

Manke¹,

Marcus²,

Page³

et al. 2003

Acta Radiologica

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“…In 6 trials, data on contrast nephropathy were not reported in the published report. 19,27,32,40,44,46 In these studies, the incidence of contrast nephropathy was obtained from the cited meta-analysis by McCullough et al 10 Among 33 studies (6293 patients) with data on sex, 74% of patients who received iodixanol were male compared with 73% of patients who received LOCM. Among 19 studies (5143 patients) with data on diabetes mellitus, 48% of patients who received iodixanol were diabetic compared with 46% of patients who received LOCM.…”

Section: Resultsmentioning

confidence: 99%

Iodixanol Versus Low-Osmolar Contrast Media for Prevention of Contrast Induced Nephropathy

From

Badarin

McDonald

et al. 2010

Circ: Cardiovascular Interventions

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Background-Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN. Methods and Results-We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, iodixanol, Visipaque, and low-osmolar contrast media. All studies reported an incidence rate of CIN for each study group; there was no restriction on the definition of CIN. There were no restrictions on journal type or patient population. Overall, 36 trials were identified for analysis of aggregated summary data on 7166 patients; 3672 patients received iodixanol and 3494 patients received LOCM. Overall, iodixanol showed no statistically significant reduction in CIN incidence below that observed with heterogeneous comparator agents (Pϭ0.11). Analysis of patient subgroups revealed that there was a significant benefit of iodixanol when compared with iohexol alone (odds ratio, 0.25; 95% confidence interval, 0.11 to 0.55; PϽ0.001) but not when compared with LOCM other than iohexol or with other ionic dimers or among patients receiving intra-arterial contrast injections or among patients undergoing coronary angiography with or without percutaneous intervention. Conclusions-Analysis

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“…23,24 Several studies that have compared the tolerability of the iso-osmolar contrast medium iodixanol with that of lowosmolar contrast medium report that iso-osmolar contrast medium is associated with a decrease in the intensity of discomfort (heat sensations) and pain. [24][25][26][27][28][29][30] Overall, the key issue that becomes important to define for each specialty is the degree of risk that makes the effort needed to screen patients, identify those at risk, and then implement prevention strategies, a requirement despite any impracticality.…”

Section: The Need For Specialty-specific Guidelinesmentioning

confidence: 99%

Contrast-Induced Acute Kidney Injury: Specialty-Specific Protocols for Interventional Radiology, Diagnostic Computed Tomography Radiology, and Interventional Cardiology

Goldfarb

McCullough

McDermott

et al. 2009

Mayo Clinic Proceedings

138

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Contrast-induced acute kidney injury (AKI) (also known as contrast-induced nephropathy) is an abrupt deterioration in renal function that can be associated with use of iodinated contrast medium. Although the increase in serum creatinine concentration is transient in most cases, contrast-induced AKI may lead to increased morbidity and mortality rates in selected at-risk populations. This review summarizes the findings of a multidisciplinary panel composed of computed tomography radiologists, interventional radiologists, cardiologists, and nephrologists convened to address the specialty-specific issues associated with minimizing the incidence of contrast-induced AKI. As part of this initiative, the panel developed specialty-specific protocols for preventing contrast-induced AKI, taking into account, for example, the variations in patient risk profile, inpatient or outpatient status, and staffing resources that characterize various clinical settings. The 3 protocols, each reflecting a consensus of expert opinion, address the prevention of contrast-induced AKI in interventional radiology, diagnostic computed tomography radiology, and interventional cardiology settings. The protocols are presented in the context of a review of recent guidelines and published reports of trials that discuss contrast-induced AKI and its prevention. © 2009 Mayo Foundation for Medical Education and ResearchA cute kidney injury (AKI) is a heterogeneous disorder with multiple etiologies, risk factors, and clinical presentations. Although patients with AKI are ultimately cared for by nephrologists, AKI occurs in various clinical settings and is associated with a specific etiology in each. The term contrast-induced AKI refers to the disorder as it occurs after exposure to iodinated contrast media, a disorder that has been more commonly known as contrastinduced nephropathy (CIN). The Acute Kidney Injury Network, recognizing the need for improving outcomes associated with the various forms of AKI, recently proposed using the following standardized diagnostic definition in all cases: an abrupt (within 48 hours) reduction in kidney function, evidenced by an increase in the serum creatinine concentration of at least 0.3 mg/dL (to convert to µmol/L, multiply by 88.4) or at least 50% from baseline or a reduction in urine output (documented oliguria of <0.5 mL/kg/h for >6 hours).1,2 The criterion of oliguria does not apply for many cases of contrast-induced AKI because patients are treated with intravenous fluids before and after the procedure with the goal of increasing periprocedural urine output. The most commonly used definition of CIN is an increase from the baseline serum creatinine concentration of at least 0.5 mg/dL or at least 25% within 48 to 72 hours after exposure to contrast media. [3][4][5] Because the medical community is moving to adopt the concept and terminology of the American College of Radiology (ACR) in reference to studies of contrast-induced renal dysfunction and its prevention, 6 this report will do the same. However, we rec...

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Iodixanol in Cardioangiography in Patients with Coronary Artery Disease

Cited by 32 publications

References 18 publications

Pain in Femoral Arteriography. A double-blind, randomized, clinical study comparing safety and efficacy of the iso-osmolar iodixanol 270 mgI/ml and the low-osmolar iomeprol 300 mgI/ml in 9 European centers

Pain in Femoral Arteriography. A double-blind, randomized, clinical study comparing safety and efficacy of the iso-osmolar iodixanol 270 mgI/ml and the low-osmolar iomeprol 300 mgI/ml in 9 European centers

Iodixanol Versus Low-Osmolar Contrast Media for Prevention of Contrast Induced Nephropathy

Contrast-Induced Acute Kidney Injury: Specialty-Specific Protocols for Interventional Radiology, Diagnostic Computed Tomography Radiology, and Interventional Cardiology

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