Increased plasma levels of PAI-1 after administration of nonionic contrast medium in patients undergoing pulmonary angiography.
OBJECTIVE
To compare the effects of ionic and nonionic contrast media on markers of the coagulation, fibrinolytic, and contact systems.


METHODS
Low-osmolar ionic (ioxaglate) or nonionic (iohexol) contrast material was administered to 14 patients undergoing pulmonary angiography for suspected pulmonary embolism. Blood samples were obtained before and after the procedure and were analyzed for fibrinolysis and coagulation indicators such as plasminogen activator type 1 (PAI-1) activity, thrombin-antithrombin III (TAT) complexes, and platelet activation.


RESULTS
Both contrast agents caused a significant increase in TAT complexes. PAI-1 levels increased significantly in patients who received iohexol but not in those who received ioxaglate. Platelet activation was more pronounced in patients who received iohexol.


CONCLUSIONS
The increase in PAI-1 levels in response to iohexol may explain clinical differences in postprocedural thrombogenicity in patients who undergo angiography.
Centre for Hemostasis, Thrombosis, Atherosclerosis, and Inflammation Research, Academic Medical Centre, University of Amsterdam, The Netherlands.
E J
EJ
Van Beek
M
M
Levi
J A
JA
Reekers
C E
CE
Hack
H R
HR
Büller
J W
JW
ten Cate
D000990:Antithrombin III / Q000032:analysis*; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D007472:Iohexol / Q000494:pharmacology; D007485:Ioxaglic Acid / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010447:Peptide Hydrolases / Q000032:analysis*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D015539:Platelet Activation / Q000187:drug effects*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011859:Radiography; D013927:Thrombosis / Q000139:chemically induced; D013997:Time Factors
D003287:Contrast Media; D017395:Plasminogen Activator Inhibitor 1; C046193:antithrombin III-protease complex; D007472:Iohexol; D000990:Antithrombin III; D010447:Peptide Hydrolases; D007485:Ioxaglic Acid