Fibrinopeptide A, prothrombin fragment 1 + 2, thrombin-antithrombin complex and D dimer before and after injection of a nonionic contrast medium (iohexol).
The principal aim of this study was to evaluate, on biochemical grounds, whether injection of a low-osmolar nonionic contrast medium (iohexol) can induce a prothrombotic state and/or a change in fibrinolysis. Fifteen patients were submitted to urographic examination and the assays listed below were performed: before the injection (T0), 1 h after (T1), and 24 h after (T24) the injection of the contrast medium. The following assays were performed: fibrinopeptide A (FPA), prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT) and D dimer (D-D). The assays were carried out on 6 of the patients to whom a saline infusion was administered. Only a mild statistically significant increase was found in FPA levels at 1 h after injection of the contrast medium (mean and CI 95%: T0 4.4, 3.7-5.5; T1 6.0, 4.9-9.1; p = 0.003). F1+2, TAT and D-D did not show any significant change after the injection. These findings show that after injection of iohexol, only a mild, though statistically significant, increase in FPA levels was observed as an expression of increased thrombin activity. In the absence of any significant increases in TAT, F 1+2 and D-D, we have no evidence of a prethrombotic state.
Sorano
G G
GG
Institute of Internal Medicine, University of Cagliari, Italy.
Paoletti
P
P
Casciu
G
G
Mameli
G
G
Marongiu
F
F
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis*; D003287:Contrast Media / Q000494:pharmacology*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005344:Fibrinopeptide A / Q000032:analysis*; D006801:Humans; D007472:Iohexol / Q000494:pharmacology*; D008875:Middle Aged; D009994:Osmolar Concentration; D010446:Peptide Fragments / Q000032:analysis*; D010447:Peptide Hydrolases / Q000032:analysis*; D011498:Protein Precursors / Q000032:analysis*; D011516:Prothrombin / Q000032:analysis*
D003287:Contrast Media; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D011498:Protein Precursors; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D005344:Fibrinopeptide A; D007472:Iohexol; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases