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Comparative study in angiocardiography in children, evaluating the side-effects of non-ionic and ionic contrast media
Insights
Non-ionic Amipaque is safer and better tolerated than ionic Isopaque Coronar for pediatric angiocardiography. This study found Amipaque significantly reduced patient discomfort and adverse effects in children with congenital heart disease.
Area of Science:
- Pediatric Cardiology
- Radiology
- Pharmacology
Background:
- Congenital heart disease diagnosis in children requires effective imaging.
- Contrast media selection impacts patient safety and diagnostic quality.
- Ionic contrast agents have been associated with adverse effects in pediatric patients.
Purpose of the Study:
- To compare the safety and efficacy of non-ionic Amipaque versus ionic Isopaque Coronar in pediatric angiocardiography.
- To evaluate patient tolerance, physiological changes, and angiogram quality between the two contrast agents.
Main Methods:
- A comparative study involving 127 pediatric patients (neonatal to 15 years) undergoing angiocardiography.
- 164 injections administered using either non-ionic Amipaque or ionic Isopaque Coronar.
- Assessment of patient discomfort, body temperature changes, heart rate alterations, extrasystoles, and angiogram quality.
Main Results:
- Amipaque showed significantly lower incidence of discomfort (9% vs. 51%) and adverse effects compared to Isopaque Coronar (p < 0.001).
- Amipaque resulted in minimal body temperature rise (0.09°C vs. 0.28°C, p < 0.001) and less heart rate variability (8.35% vs. 15.2%, p < 0.001).
- Amipaque also led to fewer extrasystoles (1.8 vs. 2.2 per injection, p < 0.05) and superior angiogram quality (p < 0.0025).
Conclusions:
- Non-ionic Amipaque is a significantly safer and better-tolerated contrast agent for pediatric angiocardiography than ionic Isopaque Coronar.
- Amipaque offers improved patient comfort, reduced physiological disturbances, and enhanced diagnostic imaging quality in pediatric cardiac procedures.
- The findings support the use of non-ionic contrast media for improved outcomes in pediatric cardiovascular imaging.
Abstract:
The study concerns 127 consecutive patients, presenting congenital heart disease, with an age distribution from neonatal to 15 years (mean 5 years). With non-ionic Amipaque, 164 injections were performed, with ionic Isopaque Coronar 81. Isopaque Coronar caused in 51% of the cases a clear discomfort for the patient; with Amipaque the side-effects were reduced to 9% (p less than 0.001). The mean body temperature rise with Amipaque was only 0.09 degrees C, against 0.28 degrees C with Isopaque Coronar (p less than 0.001). The changes in the heart rate reached 8.35% with Amipaque and 15.2% with Isopaque Coronar (p less than 0.001). Amipaque caused a mean of 1.8 extrasystoles per injection; Isopaque Coronar 2.2 (p less than 0.05). The quality of the angiogram with Amipaque was quite better than with Isopaque Coronar (p less than 0.0025). The non-ionic Amipaque is a much safer and better tolerated compound that the ionic Isopaque Coronar for paediatric angiocardiography.