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Iso-osmolar X-ray dye falters in PCI study
Date:4/1/2008

diffuse and complex coronary artery disease, invasive procedures often require the use of elevated contrast volumes."

In fact, although the risk of contrast-induced nephropathy (CIN) in patients with normal kidney function is very low (far below 1 percent), it is as high as 20 percent to 30 percent in patients with chronic kidney disease. Iodixanol, a contrast agent that has approximately the same osmolarity as blood, was designed to reduce the stress on the kidneys and significantly cut the risk of CIN when compared to contrast medium with a higher osmolarity.

For the study, Dr. Wessely and his colleagues recruited 324 patients with at least mild renal insufficiency (serum creatinine 1.5 mg/dL or an estimated glomerular filtration rate < 60 mL/min/1.73m2) who needed PCI for coronary artery disease. Patients were randomly assigned to receive either iso-osmolar iodixanol (290 mOsm/L) or low-osmolar iomeprol (618 mOsm/L) contrast medium during PCI. All patients received intravenous hydration with a saline solution both before and after the procedure.

Researchers found that the proportion of patients who developed CIN was similar in the two groups (22.2 percent in the iodixanol group vs. 27.7 percent in the iomeprol group, p=0.25). Rates of severe CIN were not significantly different (6.2 percent vs. 3.7 percent, respectively, p=0.30). The need for dialysis was low in both groups (1.9 percent vs. 0.6 percent, p=0.31). Patients remained in the hospital an average of 6.3 days and 6.5 days, respectively (p=0.59).

Clinical outcomes were similar as well. After 90 days of follow-up, there was no significant difference in individual and combined rates of heart attack, death and repeat coronary procedure.

Dr. Wessely will present the results of the "The Contrast Media and Nephrotoxicity Following Coronary Revascularization by Angioplasty (CONTRAST) study on Tuesday, April 1 at 11:45 a.m. CDT in the Grand Ballroom, S100.


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Contact: Kathy Boyd David
pr@scai.org
717-422-1181
Weber Shandwick Worldwide
Source:Eurekalert

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