One‐year results of the <scp>ICON</scp> (ionic versus non‐ionic contrast to obviate worsening nephropathy after angioplasty in chronic renal failure patients) Study

Giustino, Gennaro; Baber, Usman; Mastoris, Ioannis; Vlachojannis, Georgios J.; Yu, Jennifer; Teirstein, Paul S.; Downey, William; Batchelor, Wayne; Casterella, Peter J.; Nikolsky, Eugenia; Wong, S. Chiu; Theodoropoulos, Kleanthis; Dangas, George; Mehran, Roxana

doi:10.1002/ccd.26106

Cited by 12 publications

(19 citation statements)

References 22 publications

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“…However, our results indicated that use of NAC showed no protective effect of CI-AKI in diabetic patients, which were similar with other studies [33, 34]. A recent study showed ionic LOCM ioxaglate was associated with a numerically lower one-year mortality than iodixanol in patients with cardiac catheterization [35], which were inconsistent with our results. Therefore, future studies evaluating long-term safety following exposure to different types of contrast media in diabetic patients are warranted.…”

Section: Discussioncontrasting

confidence: 68%

Comparative effect of iso-osmolar versus low-osmolar contrast media on the incidence of contrast-induced acute kidney injury in diabetic patients: a systematic review and meta-analysis

et al. 2019

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Background Contrast-induced acute kidney injury (CI-AKI) is a major adverse effect caused by intravascular administration of iodinated contrast medium. Whether there is a difference in CI-AKI incidence between iso-osmolar (IOCM) and low-osmolar contrast media (LOCM) among diabetic patients is controversial. Methods Randomized controlled trials comparing the nephrotoxic effects between IOCM and LOCM in diabetic patients with or without CKD (eGFR< 60 ml/min/1.73 m 2 ) were included in the analysis. The incidence of CI-AKI was defined as an initial increase in serum creatinine (SCr) concentration of at least 0.5 mg/dl or a rise in creatinine of 25% from baseline. Results A total of 2190 patients were included, among whom 1122 patients received IOCM and 1068 received LOCM. When compared to LOCM, IOCM had no significant benefit in preventing CI-AKI (OR = 1.66, [CI: 0.97–2.84], P = 0.06, I 2 = 54%). However, the difference between IOCM and LOCM was found when CI-AKI was defined as an absolute SCr increase (≥0.5 mg/dl) rather than a relative SCr increase (≥25%). Further analysis showed that LOCM resulted in more adverse events. Conclusions Whether there is a difference of CI-AKI incidence between IOCM and LOCM in diabetic patients was related to the selected diagnostic criteria. The incidence of adverse events was significantly lower with IOCM when compared with LOCM. Therefore, we suggest that IOCM may be used in diabetic and CKD (eGFR< 60 ml/min/1.73 m 2 ) patients. Electronic supplementary material The online version of this article (10.1186/s40644-019-0224-6) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 68%

Comparative effect of iso-osmolar versus low-osmolar contrast media on the incidence of contrast-induced acute kidney injury in diabetic patients: a systematic review and meta-analysis

et al. 2019

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“…The study was a relatively small randomized controlled trial and underpowered for AKI. The present paper in Catheterization and Cardiovascular Interventions by Giustino et al examines the 30‐day and one year results of the ICON trial with respect to renal failure and mortality . There were no differences in renal outcomes and a numerically (but not statistically significant) higher rate of death at one year in the iodixanol group versus the group ioxaglate (9.1% vs. 2.7%, P = 0.07).…”

mentioning

confidence: 82%

Can our choice of contrast media impact renal and cardiovascular outcomes?

Prasad

Gurm

2016

Cathet Cardio Intervent

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Key Points Contrast media vary in their ionic status, viscosity, osmolarity—and these factors all play into clinical effects. Iso‐osmolar and low‐osmolar contrast media dominate clinical use today. The differences between these two agents in terms of kidney injury remain uncertain. Ionic agents have theoretical properties which may help prevent thrombus formation; however this phenomenon has not translated to differences in clinical outcomes.

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“…Of the works found, four countries contributed to the studies: two from the United States (18,20) , one from Brazil (19) , one from Turkey (21) and one from Japan (22) . All articles present were in English.…”

Section: Countriesmentioning

confidence: 99%

“…Only one study outlined the clinical and sociodemographic profile of patients who developed CIN (18) ; however, CIN incidence varied between 6% to 24% (18)(19)(20)(21)(22) . It was observed that the study samples vary from 135 to 2552 people (18)(19)(20)(21)(22) . Analyzing the publications that make up this review, it can be seen that, in general, there was a difference in renal involvement according to the social indicators of sex and age.…”

Section: Epidemiologymentioning

confidence: 99%

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Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review

et al. 2020

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Objective: to demonstrate scientific evidence on incidence and factors associated with contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Methods: an integrative review carried out in the VHL, PubMed, VHL Regional Portal and SciELO databases, of articles published between 2014 and 2019. Results: the sample consisted of five original articles, two cohorts, two control cases and a clinical trial. The incidence of contrast-induced nephropathy ranged from 6% to 24%. It stands out among patients with advanced age, male gender, diabetes mellitus, systemic arterial hypertension, volume of contrast infused and osmolarity. Intravenous hydration, sodium bicarbonate, ascorbic acid and statin were important prophylactic agents. Conclusion: this study envisioned the main risk factors for contrast-induced nephropathy in patients undergoing percutaneous coronary intervention and elucidated preventive measures that guide multidisciplinary health care aiming at a quality and safe care.

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One‐year results of the ICON (ionic versus non‐ionic contrast to obviate worsening nephropathy after angioplasty in chronic renal failure patients) Study

Abstract: The use of ionic LOCM ioxaglate was associated with a numerically lower mortality at 1 year as compared to iodixanol in patients who underwent cardiac catheterization. Future studies evaluating long-term safety following exposure to different types of CM are warranted.

Cited by 12 publications

References 22 publications

Comparative effect of iso-osmolar versus low-osmolar contrast media on the incidence of contrast-induced acute kidney injury in diabetic patients: a systematic review and meta-analysis

Comparative effect of iso-osmolar versus low-osmolar contrast media on the incidence of contrast-induced acute kidney injury in diabetic patients: a systematic review and meta-analysis

Can our choice of contrast media impact renal and cardiovascular outcomes?

Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review

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