Effect of Contrast Media Type on Renal Function in Percutaneous Coronary Intervention (PCI): A Propensity...

Objective To compare the effects of two low-osmolar contrast media (LOCM), iohexol and iomeprol, on renal function in patients undergoing percutaneous coronary intervention (PCI), as measured by estimated glomerular filtration rate (eGFR). Methods This retrospective study included 180 patients who underwent PCI between January 2021 and December 2022. After propensity score matching based on age, sex, diabetes mellitus, pre-PCI eGFR, contrast media volume, and left ventricular ejection fraction, 88 patients who received either iohexol or iomeprol (44 each) were analyzed. Changes in eGFR at 24 hours and more than 72 hours post-PCI were evaluated. Results There were no differences between the two groups in age [median 71.5 (range 33-86) vs. 73 (range 50-83) years], gender [35 (79.5%) vs. 37 (84.1%) male], pre-PCI eGFR [64.9 (6.8-112.2) vs. 61.3 (8.5-105.2) ml/min/1.73m²], or amount of LOCM used [108 (42-217) vs. 109 (52-222) ml] between the iohexol and iomeprol groups, respectively. No significant differences in absolute or relative changes in eGFR were observed between the two groups at either time point. At 24 hours, the mean relative change in eGFR was 1.6% (-2.5 to 5.8) in the iohexol group and 1.1% (-2.8 to 4.9) in the iomeprol group. At more than 72 hours, relative changes were -2.1% (-5.9 to 1.7) and -0.3% (-4.4 to 3.8), respectively. No cases of post-contrast acute kidney injury were observed.  Conclusion Changes in renal function after PCI did not differ significantly between iohexol and iomeprol, despite differences in osmolality and viscosity.