An analysis of platelet activation and aggregation produced by three classes of contrast media.
OBJECTIVE
To evaluate the platelet activation and aggregation produced by ionic high-osmolality contrast media (HOCM) and both ionic and nonionic low-osmolality contrast media (LOCM).


METHODS
After each agent was mixed with heparinized blood, sequential platelet counts were used to monitor platelet aggregation, and flow cytometry was used to monitor both aggregation and activation. Aggregation was measured with CD41a-FITC (specific for glycoprotein IIb-IIIa) and activation was measured with CD62-PE (specific for P-selectin).


RESULTS
High concentrations of the nonionic LOCM (> 31% by volume in whole blood) induced more than 90% platelet activation within 2 minutes of exposure to freshly drawn heparinized whole blood. Aggregation followed immediately after activation and was somewhat reversible. High concentrations of the ionic HOCM (> 31%) induced prominent activation, although it occurred at a much slower rate and to a lesser degree than with the nonionic media. There was approximately 70% activation after 45 minutes of exposure. Ionic HOCM inhibited platelet aggregation, however. The ionic LOCM ioxaglate produced minimal or no platelet aggregation or activation.


CONCLUSIONS
There is likely to be an agent-related difference in the risk of platelet activation and aggregation in the catheter lumen and in the immediate environment of the catheter tip, where high concentrations of contrast media are known to exist.
Hay
K L
KL
Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, CA 92354, USA.
Bull
B S
BS
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D002406:Catheterization, Peripheral / Q000295:instrumentation; D015815:Cell Adhesion Molecules / Q000032:analysis; D003287:Contrast Media / Q000145:classification / Q000494:pharmacology*; D003973:Diatrizoate / Q000494:pharmacology; D005434:Flow Cytometry; D006801:Humans; D007472:Iohexol / Q000494:pharmacology; D007479:Iopamidol / Q000494:pharmacology; D007485:Ioxaglic Acid / Q000494:pharmacology; D009994:Osmolar Concentration; D019007:P-Selectin; D015539:Platelet Activation / Q000187:drug effects*; D010974:Platelet Aggregation / Q000187:drug effects*; D010976:Platelet Count; D010980:Platelet Membrane Glycoproteins / Q000032:analysis; D013997:Time Factors; D014283:Triiodobenzoic Acids / Q000494:pharmacology
D015703:Antigens, CD; D015815:Cell Adhesion Molecules; D003287:Contrast Media; D019007:P-Selectin; D010980:Platelet Membrane Glycoproteins; D014283:Triiodobenzoic Acids; D003973:Diatrizoate; D007472:Iohexol; D007479:Iopamidol; C054871:ioversol; D007485:Ioxaglic Acid