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Long-Term Adverse Effects of Low-Osmolar Compared With Iso-Osmolar Contrast Media After Coronary Angiography

Yuan-Cheng Wang1, Adrian Tang2, Di Chang1

  • 1Department of Radiology, Jiangsu Key Laboratory of Molecular and Functional Imaging, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.

The American Journal of Cardiology
|August 14, 2016
PubMed

Insights

Long-term adverse effects of low-osmolar contrast media (LOCM) and iso-osmolar contrast media (IOCM) after coronary angiography are comparable overall. However, LOCM may increase long-term mortality risk in chronic kidney disease patients.

Area of Science:

  • Cardiology
  • Radiology
  • Nephrology

Background:

  • The comparative long-term safety of low-osmolar contrast media (LOCM) and iso-osmolar contrast media (IOCM) following coronary angiography remains incompletely understood.
  • Contrast media are essential for cardiovascular imaging but carry potential risks.

Purpose of the Study:

  • To compare the long-term incidence of adverse effects, specifically all-cause mortality and renal injury, between LOCM and IOCM in patients undergoing coronary angiography.
  • To investigate potential differences in mortality risk within specific patient subgroups, such as those with chronic kidney disease.

Main Methods:

  • A retrospective analysis of cardiology patients who underwent coronary angiography between January 2006 and July 2013.
  • Patients received either LOCM (iohexol, iopromide) or IOCM (iodixanol).
  • Inverse probability weighting (IPW) and multivariate Cox regression were used to adjust for selection bias and compare primary (all-cause mortality) and secondary outcomes (long-term renal injury, cardiovascular events).

Main Results:

  • Unadjusted analysis showed lower all-cause mortality with LOCM compared to IOCM (HR 0.28).
  • After adjustment using multivariate Cox regression or IPW, all-cause mortality became comparable between LOCM and IOCM groups.
  • The chronic kidney disease subgroup exhibited a trend towards higher long-term mortality with LOCM compared to IOCM (IPW-adjusted HR 1.57).

Conclusions:

  • Following coronary angiography, overall long-term mortality is comparable between patients receiving LOCM and IOCM after statistical adjustment.
  • LOCM may be associated with a tendency for increased long-term mortality in patients with chronic kidney disease compared to IOCM.

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