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Effect of an ionic compared to a non-ionic X-ray contrast agent on platelets and coagulation during diagnostic

F Jung1, S G Spitzer, G Pindur

  • 1Dresdner Institut für Herz- und Kreislaufforschung, Dresden, Germany. dihkf@saarmail.de

Pathophysiology of Haemostasis and Thrombosis
|October 10, 2002
PubMed

Insights

Ionic contrast media (ioxaglate) show lower thrombin generation and platelet activation compared to non-ionic media (iopromide) during coronary angiography. This study confirms previous in vitro and animal findings on contrast media effects on hemostasis.

Area of Science:

  • Cardiology
  • Hematology
  • Radiology

Background:

  • Contrast media are essential in diagnostic imaging, but their effects on hemostasis require careful evaluation.
  • Ionic and non-ionic contrast agents differ in their chemical properties, potentially influencing biological systems.
  • Previous in vitro and animal studies suggested differences in hemostatic effects between ionic and non-ionic contrast media.

Purpose of the Study:

  • To compare the ex vivo effects of ionic (ioxaglate) and non-ionic (iopromide) contrast media on hemostatic parameters.
  • To assess the impact of these contrast media on platelet function and coagulation markers in patients undergoing coronary angiography.

Main Methods:

  • Ex vivo analysis of blood samples from 40 patients undergoing coronary angiography.
  • Measurement of platelet function, including platelet reactivity and serotonin concentration.
  • Assessment of coagulation markers: thrombin-antithrombin III complexes, prothrombin fragments (F1+2), and D-dimers.

Main Results:

  • Ionic X-ray contrast agent (XCA) ioxaglate was associated with significantly lower thrombin generation compared to non-ionic XCA iopromide.
  • Platelet system activation was lower when using the ionic contrast agent ioxaglate.
  • These findings were consistent across measured platelet function and coagulation markers.

Conclusions:

  • Ionic contrast media, specifically ioxaglate, demonstrate a less prothrombotic and platelet-activating profile compared to non-ionic contrast media like iopromide.
  • The study validates previous in vitro and animal research in a clinical setting.
  • These findings have implications for selecting contrast agents in procedures like coronary angiography to minimize hemostatic disturbances.

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