Contrast media-related complications during cardiac catheterization using Hexabrix or Renografin in high-risk patients.
Contrast media may lead to adverse reactions during cardiac catheterization. Hexabrix has less hemodynamic and electrophysiologic effects than Renografin-76. To assess relative complication rates using these agents, 82 patients with heart failure or "unstable" ischemic syndromes and undergoing catheterization were prospectively randomized to receive either Hexabrix or Renografin. Clinical diagnoses, hemodynamics before contrast media administration, left ventricular ejection fraction, case duration, contrast volume and cine film quality were similar in the 2 groups. The condition of 1 patient assigned to receive Renografin was deemed too unstable and Hexabrix was safely used. In the other patients, a total of 17 adverse reactions occurred (7 before administration of contrast and thus unrelated: 4 Hexabrix- and 3 Renografin-assigned patients, difference not significant). Three contrast-induced adverse reactions were considered minor (Hexabrix 2, Renografin 1, difference not significant). Severe adverse reactions requiring intervention, such as pulmonary edema and hypotension, were more frequent in patients who received Renografin (6 of 38, 16%) as compared with Hexabrix (1 of 43, 2%) (p less than 0.05). It is concluded that in high-risk patients undergoing cardiac catheterization, Hexabrix is tolerated better than Renografin and should be considered for routine use.
Feldman
R L
RL
Department of Medicine, University of Florida, Gainesville.
Jalowiec
D A
DA
Hill
J A
JA
Lambert
C R
CR
D000790:Angiocardiography; D006328:Cardiac Catheterization; D002986:Clinical Trials as Topic; D003287:Contrast Media / Q000009:adverse effects*; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D003974:Diatrizoate Meglumine / Q000009:adverse effects*; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007485:Ioxaglic Acid / Q000009:adverse effects*; D011446:Prospective Studies; D011897:Random Allocation; D012307:Risk Factors
D003287:Contrast Media; D003974:Diatrizoate Meglumine; D007485:Ioxaglic Acid