[Activation of blood coagulation and fibrinolysis after angiocardiography with ionic and non-ionic contrast media].
OBJECTIVE
To study the effects of a ionic (amidotrizoate) and a non-ionic x-ray contrast medium (iopromid) during routine levocardiography and coronary angiography, we employed assays that detect reaction products of thrombin and plasmin to assess the activation of the haemostatic system.


METHODS
Subsequent to informed consent, 20 patients were randomly assigned to receive either amidotrizoate or iopromid during standard levocardiography and coronary angiography in a double-blind comparative study. Groups were comparable in respect of age, weight, sex and severity of the disease. No anticoagulation was provided. Coronary angiography was performed according to a standardised protocol. Consumption of contrast media and duration of the examination were comparable in both groups.


RESULTS
Thrombin generation (F.1+2) and thrombin activity (TAT) were higher with the ionic contrast medium but did not attain statistical significance. Fibrin generation and degradation as expressed by D-dimer fibrin split products was significantly increased in patients who had been receiving amidotrizoate (p < 0.05, U-Test).


CONCLUSIONS
The non-ionic x-ray contrast medium induced significantly less haemostatic activation in vivo than did the ionic medium amidotrizoate. These data suggest that earlier in vitro observations of more pronounced anticoagulant effects of ionic x-ray contrast media are of limited significance for the evaluation of in vivo effects of x-ray contrast media on haemostatic function.
Winkler
U H
UH
Zentrum für Frauenheilkunde, Universitätsklinikum Essen.
Park
J W
JW
Weber
S
S
Kothe
A
A
Schnitker
J
J
Behrends-Steins
B
B
Albring
M
M
D000790:Angiocardiography; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D003287:Contrast Media / Q000494:pharmacology*; D017023:Coronary Angiography; D003973:Diatrizoate / Q000494:pharmacology*; D004311:Double-Blind Method; D005337:Fibrin / Q000378:metabolism; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives* / Q000494:pharmacology; D008875:Middle Aged; D013917:Thrombin / Q000378:metabolism; D013997:Time Factors
D003287:Contrast Media; D005338:Fibrin Fibrinogen Degradation Products; D003973:Diatrizoate; D007472:Iohexol; C038192:iopromide; D005337:Fibrin; D013917:Thrombin