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Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
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Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

Peter A McCullough1, Guy David2, Thomas M Todoran3

  • 1Baylor University Medical Center, Dallas, TX; Baylor Heart & Vascular Institute, Dallas, TX; Baylor Jack & Jane Hamilton Heart & Vascular Hospital, 621 N Hall St #H030, Dallas, TX 75226; Texas A&M Health Science Center College of Medicine, Dallas Campus, Dallas TX, USA.

Journal of Comparative Effectiveness Research
|November 10, 2017
PubMed

Insights

Iso-osmolar contrast media (IOCM) may reduce major adverse renal and cardiovascular events (MARCE) in patients undergoing angioplasty compared to low-osmolar contrast media (LOCM). This finding suggests IOCM could improve patient outcomes in interventional cardiology.

Area of Science:

  • Interventional Cardiology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Contrast media (CM) are essential for angioplasty procedures.
  • Assessing the safety of different CM types is crucial for patient outcomes.
  • Major adverse renal and cardiovascular events (MARCE) are significant complications.

Purpose of the Study:

  • To evaluate the association between iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) and MARCE.
  • To determine if CM type influences adverse event rates in angioplasty patients.

Main Methods:

  • Retrospective analysis of 333,533 angioplasty visits across 357 hospitals.
  • Stratification of visits into IOCM and LOCM cohorts.
  • Multivariable regression analysis with hospital fixed effects to assess MARCE risk.

Main Results:

  • The overall incidence of MARCE was 7.41%.
  • Administration of IOCM, compared to LOCM, was associated with a 0.69% absolute risk reduction in MARCE.
  • A 9.32% relative risk reduction in MARCE was observed with IOCM use.

Conclusions:

  • IOCM may be associated with a reduction in MARCE compared to LOCM in patients undergoing coronary or peripheral angioplasty.
  • Findings suggest IOCM could be a safer contrast media choice for reducing adverse events in this patient population.
Abstract

Keywords:
angioplastylow-osmolar contrast mediamajor adverse renal and cardiovascular events (MARCE)relative risk

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