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Association between Contrast Media Volume and 1-Year Clinical Outcomes in Patients Undergoing Coronary Angiography
Ying-Qing Feng1, Xu-Yu He1, Fei-Er Song1
1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
Insights
Higher contrast media volume during cardiac catheterization is linked to increased risks of major adverse cardiac and cerebrovascular events and bleeding. This study highlights the importance of monitoring contrast dose in patients undergoing coronary angiography.
Area of Science:
- Cardiology
- Interventional Cardiology
- Radiology
Background:
- Excess contrast media (CM) volume in cardiac procedures correlates with lesion severity and intervention length.
- The direct impact of CM volume on clinical outcomes remains unclear.
- This study investigates the association between CM dose and adverse events post-cardiac catheterization.
Purpose of the Study:
- To determine the relationship between contrast volume and 1-year major adverse cardiac and cerebrovascular events (MACCE).
- To assess the correlation between contrast dose and all-cause bleeding events.
- To evaluate contrast volume as a predictor of clinical outcomes in cardiac catheterization patients.
Main Methods:
- Prospective enrollment of 10,961 patients undergoing coronary angiography (CAG) from 2012-2013.
- 1-year follow-up to track MACCE and bleeding events.
- Logistic regression analysis to assess the predictive value of contrast volume quartiles.
Main Results:
- 1-year MACCE incidence was 8.65%, increasing with contrast volume (Q1: 7.16% to Q4: 11.73%, P < 0.001).
- 1-year all-cause bleeding incidence also rose with contrast volume (Q1: 4.70% to Q4: 8.21%, P < 0.001).
- Contrast volume >140 ml was associated with higher MACCE, dramatically elevated above 200 ml (P = 0.007).
Conclusions:
- Higher contrast media volume is significantly associated with increased MACCE risk.
- Increased contrast volume is also correlated with a higher incidence of all-cause bleeding events.
- Monitoring and potentially limiting contrast dose may be crucial for improving patient outcomes in cardiac catheterization.
Background:
The excess volume of contrast media (CM) is a marker of a more severe coronary culprit lesion and longer intervention duration in patients undergoing cardiac procedures. However, it is unclear whether the contrast volume is directly correlated with worse clinical outcomes. The aim of this study was to investigate the association between contrast dose and the incidence of 1-year major adverse cardiac and cerebrovascular events (MACCE) and all-cause bleeding events in patients undergoing cardiac catheterization and coronary angiography (CAG).
Methods:
We prospectively enrolled 10,961 consecutive patients diagnosed with coronary heart disease expecting CAG from 2012 to 2013. The study population was pursued with a follow-up duration of 1 year. The predictive value of contrast volume, divided into quartiles, for the risk of MACCE and all-cause bleeding events was assessed using logistic regression analysis.
Results:
The cumulative incidence of 1-year MACCE was 8.65%, which was directly associated with increasing contrast volume. In particular, MACCE was observed in 7.16%, 7.89%, 9.31%, and 11.73% of cases in the contrast volume quartile Q1 (≤100 ml), Q2 (101-140 ml), Q3 (141-200 ml), and Q4 (>200 ml), respectively (P < 0.001). Moreover, the incidence of 1-year all-cause bleeding events was noted in 4.70%, 5.93%, 7.28%, and 8.21% of patients in Q1, Q2, Q3, and Q4, respectively (P < 0.001). The survival analysis showed that the 1-year MACCE rate was higher in patients using greater CM volume during the CAG. CM volume used >140 ml was associated with the occurrence of 1-year MACCE, and the incidence was dramatically elevated in patients exceeding a contrast volume of 200 ml (P = 0.007).
Conclusion:
Our data suggested that higher contrast volume was significantly correlated with an increased risk of MACCE and all-cause bleeding events in patients undergoing cardiac catheterization.
Trial Registration:
ClinicalTrials.gov, NCT01735305; https://clinicaltrials.gov/ct2/show/NCT01735305?id=NCT017353057rank=1.
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