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Iodixanol versus iopromide in patients with renal insufficiency undergoing coronary angiography with or without PCI.

Abstract The use of contrast agents during coronary angiography can result in contrast-induced nephropathy (CIN), particularly in patients with renal dysfunction. On the contrary, different contrast agents can induce different degree of changes in cardiac function. The objective of our meta-analysis was to compare the clinical safety of iso-osmolar contrast medium iodixanol to low-osmolar contrast medium iopromide in patients with renal insufficiency undergoing coronary angiography with or without percutaneous coronary intervention (PCI).
PMID
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Comparison of contrast-induced nephrotoxicity of iodixanol and iopromide in patients with renal insufficiency undergoing coronary angiography.

Authors

Mayor MeshTerms

Percutaneous Coronary Intervention

Keywords
Journal Title medicine
Publication Year Start




PMID- 29718868
OWN - NLM
STAT- MEDLINE
DCOM- 20180508
LR  - 20180508
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 18
DP  - 2018 May
TI  - Iodixanol versus iopromide in patients with renal insufficiency undergoing
      coronary angiography with or without PCI.
PG  - e0617
LID - 10.1097/MD.0000000000010617 [doi]
AB  - BACKGROUND: The use of contrast agents during coronary angiography can result in 
      contrast-induced nephropathy (CIN), particularly in patients with renal
      dysfunction. On the contrary, different contrast agents can induce different
      degree of changes in cardiac function. The objective of our meta-analysis was to 
      compare the clinical safety of iso-osmolar contrast medium iodixanol to
      low-osmolar contrast medium iopromide in patients with renal insufficiency
      undergoing coronary angiography with or without percutaneous coronary
      intervention (PCI). METHODS: We searched Medline, Embase, Cochrane Library, and
      reference lists to identify randomized controlled trials that compared iodixanol 
      to iopromide with the incidence of CIN as an endpoint in renal impaired patients 
      undergoing coronary angiography. Outcome measures were the incidence of CIN,
      absolute peak serum creatinine (Scr) increase from baseline and a composite of
      cardiovascular adverse events. RESULTS: A total of 8 trials with 3532 patients
      were pooled; 1759 patients received iodixanol and 1773 patients received
      iopromide. There was no significant difference in the incidence of CIN (summary
      odds ratio [OR] 0.50, 95% confidence interval [CI] 0.19-1.35, P = .17) and peak
      Scr increase (mean difference -0.01 mg/dL, 95% CI -0.08 to 0.05, P = .69) when
      iodixanol was compared with iopromide. But iodixanol was associated with a
      statistically significant reduction in cardiovascular adverse events when
      compared with iopromide (OR 0.47, 95% CI 0.30-0.73, P = .0009). CONCLUSIONS:
      Analysis of pooled data from 8 randomized controlled trials of iodixanol against 
      iopromide in patients with renal insufficiency undergoing coronary angiography
      with or without PCI showed that iodixanol nonsignificantly reduced the incidence 
      of CIN, but was associated with a significantly reduced risk of cardiovascular
      adverse events when compared with iopromide.
FAU - Zhang, Junyi
AU  - Zhang J
AD  - Department of Cardiology, the First Affiliated Hospital of Soochow University,
      Suzhou City, Jiangsu Province, P.R. China.
FAU - Jiang, Yufeng
AU  - Jiang Y
FAU - Rui, Qing
AU  - Rui Q
FAU - Chen, Min
AU  - Chen M
FAU - Zhang, Nannan
AU  - Zhang N
FAU - Yang, Huajia
AU  - Yang H
FAU - Zhou, Yafeng
AU  - Zhou Y
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Contrast Media)
RN  - 0 (Triiodobenzoic Acids)
RN  - 4419T9MX03 (Iohexol)
RN  - 712BAC33MZ (iopromide)
RN  - AYI8EX34EU (Creatinine)
RN  - HW8W27HTXX (iodixanol)
SB  - AIM
SB  - IM
MH  - Contrast Media/*adverse effects
MH  - Coronary Angiography/*methods
MH  - Creatinine/blood
MH  - Humans
MH  - Iohexol/adverse effects/*analogs & derivatives
MH  - Kidney Diseases/blood/*chemically induced
MH  - *Percutaneous Coronary Intervention
MH  - Renal Insufficiency/*complications
MH  - Triiodobenzoic Acids/*adverse effects
EDAT- 2018/05/03 06:00
MHDA- 2018/05/09 06:00
CRDT- 2018/05/03 06:00
PHST- 2018/05/03 06:00 [entrez]
PHST- 2018/05/03 06:00 [pubmed]
PHST- 2018/05/09 06:00 [medline]
AID - 10.1097/MD.0000000000010617 [doi]
AID - 00005792-201805040-00036 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(18):e0617. doi: 10.1097/MD.0000000000010617.