[Effects of ionic and nonionic contrast media on the blood coagulation system, the fibrinolytic system and platelets]

Effects of ionic and nonionic contrast media (CM) on blood coagulation, fibrinolytic system and platelet function were comparatively studied in vitro. By the gross observation of blood coagulation using mixture 2:8 of each contrast media and blood, its total coagulation time was clearly short with iopamidol and iohexol, and no complete coagulation was observed with ioxaglate and diatrizoate for 180 minutes. Anticoagulant effects of all CM were confirmed by the assays of APTT, PT, thrombin time, antithrombin III, FPA, TAT and anti-Xa activity. But, the ionic high osmolar CM (diatrizoate) and low osmolar CM (ioxaglate) showed a greater anticoagulant effect than nonionic CM. Anticoagulant effect of CM on coagulation system may be mainly caused by antithrombin effect. No effects of CM on the fibrinolytic system were observed by assays of the D-dimer, plasminogen and antiplasmin. And all the contrast media produced inhibitory effects of platelet aggregation induced by ADP. Ionic CM tended to have a little stronger inhibitory effect than non-ionic CM. In conclusion, it was suggested that a greater anticoagulant effect of ioxaglate ensures potential safety for thromboembolic complication during angiographic procedure.