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Experiences with iohexol and iodixanol during cardioangiography in an unselected patient population
1Department of Radiology, Göteborg University, Sahlgrenska University Hospital, SE 413 45 Göteborg, Sweden. agneta.flinck@xray.gu.se
Insights
Iodixanol showed a lower frequency of cardiac adverse events compared to iohexol, particularly in older patients and those with unstable angina. This suggests iodixanol may be a safer choice for high-risk patients undergoing cardioangiography.
Area of Science:
- Cardiology
- Radiology
- Pharmacology
Background:
- Cardioangiography utilizes contrast media to visualize coronary arteries.
- Iohexol and iodixanol are commonly used iodinated contrast agents.
- Assessing adverse events associated with contrast media is crucial for patient safety.
Purpose of the Study:
- To compare the incidence of adverse events following cardioangiography using iohexol versus iodixanol.
- To evaluate contrast media safety in specific patient subgroups, including elderly individuals, those with severe coronary artery disease, unstable angina, and left ventricular dysfunction.
Main Methods:
- An open, prospective, cross-sectional study involving 1020 patients undergoing cardioangiography.
- Patients received either iodixanol (320 mgI/ml) or iohexol (350 mgI/ml).
- Adverse events were systematically recorded, and patient questionnaires were utilized.
Main Results:
- Overall cardiac adverse events (CAE) were reported by 9% of patients receiving iohexol and 7% receiving iodixanol.
- Two cases of ventricular fibrillation occurred, both associated with iohexol.
- In patients aged 65 years or older, CAE incidence was 11% with iohexol versus 7% with iodixanol.
- Patients with unstable angina pectoris experienced more CAE with iohexol (18%) compared to iodixanol (12%).
Conclusions:
- Iodixanol may offer a safety advantage over iohexol in patients undergoing cardioangiography, especially in those with unstable angina.
- The findings suggest a potential benefit of iodixanol in reducing cardiac adverse events in specific high-risk patient populations.
Aim:
To compare the frequency of adverse events after cardioangiography with iohexol and iodixanol in an unselected patient population with special regard to previously defined "risk patients": age> or =65 years, severe coronary artery disease, unstable angina pectoris and left ventricular dysfunction.
Methods:
A total of 1020 patients referred to cardioangiography were included in this open, prospective cross-sectional study, comparing iodixanol (320 mgI/ml) and iohexol (350 mgI/ml). Adverse events were recorded and the patients answered a questionnaire.
Results:
Cardiac adverse events (CAE) i.e., angina pectoris, arrhythmia and dyspnea within 24 h of examination were reported by 9% of patients receiving iohexol and by 7% receiving iodixanol. Two cases of ventricular fibrillation occurred, both after iohexol. The proportion of CAE was 11% for patients> or =65 years receiving iohexol and 7% in younger patients. For patients receiving iodixanol the proportion was 7%, in both age groups. Patients with severe coronary disease had more CAE than less ill patients in both CM groups. The proportion of unstable patients with CAE was 18% in the iohexol group and 12% in the iodixanol group. Left ventricular dysfunction was not related to CAE.
Conclusions:
Iodixanol could be advantageous in patients with unstable angina.