Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

Author:

McCullough Peter A1,David Guy2,Todoran Thomas M3,Brilakis Emmanouil S4,Ryan Michael P5,Gunnarsson Candace5

Affiliation:

1. Baylor 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

2. Wharton School, University of Pennsylvania, 202 Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, USA

3. Medical University of South Carolina, 25 Courtenay Drive MSC 592, Charleston, SC 29425, USA

4. Minneapolis Heart Institute & University of Texas Southwestern Medical Center, 920 E 28th St #300, Minneapolis, MN 55407, USA

5. CTI Clinical Trial & Consulting Services, 100 E RiverCenter Blvd, Covington, KY 41011, USA

Abstract

Aim: To assess the relationship between type of contrast media (CM), iso-osmolar contrast media (IOCM) or low-osmolar contrast media (LOCM), and major adverse renal and cardiovascular events (MARCE). Materials & methods: Coronary or peripheral angioplasty visits were stratified into CM cohorts: IOCM or LOCM. Multivariable regression analysis used hospital fixed effects to assess the relationship between MARCE events and type of CM. Results: Among 333,533 visits (357 hospitals), the incidence of MARCE was 7.41%. After controlling for observable and unobservable time invariant within-hospital characteristics, administration of IOCM versus LOCM was associated with a 0.69% absolute and 9.32% relative risk reduction in MARCE rate. Conclusion: Our study indicates that as compared with LOCM, IOCM may be associated with reduction of MARCE events in coronary or peripheral angioplasty patients.

Publisher

Future Medicine Ltd

Subject

Health Policy

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