Acute and subacute stent occlusion; risk-reduction by ionic contrast media.
OBJECTIVE
Current data concerning the influence of X-ray contrast media on the incidence of thrombotic complications in interventional cardiology are controversial. The effect of ionic contrast media on acute (< or =72 h) and subacute (< or =30 days) stent thrombosis has not been investigated.


METHODS
Three thousand, nine hundred and ninety consecutive patients underwent coronary stent placement. Group I (n=1808) received non-ionic contrast media while group II (n=2182) was given the ionic Ioxaglate. All patients were treated with a standard regimen of aspirin and ticlopidine for 4 weeks post intervention.


RESULTS
Both acute and subacute stent occlusion occurred more frequently in patients receiving non-ionic contrast media compared to ionic contrast media (acute stent occlusion: 1.3% in group I vs 0.3% in group II, P=0.001; subacute stent occlusion: 2.4% in group I vs 0.7% in group II, P=0.001). The incidence of the combined clinical end-point of coronary artery bypass grafting, target lesion revascularization, and overall mortality within 12 months was significantly reduced by the use of Ioxaglate (22.9% vs 16.3%, P=0.001).


CONCLUSIONS
Based upon these data, we recommend the use of Ioxaglate in coronary interventions when stent placement is anticipated.
Scheller
B
B
Division of Internal Medicine III , University of Saarland, Homburg/Saar, Germany.
Hennen
B
B
Pohl
A
A
Schieffer
H
H
Markwirth
T
T
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007485:Ioxaglic Acid / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000009:adverse effects; D012307:Risk Factors; D015607:Stents; D019467:Subacute Care; D016896:Treatment Outcome
D003287:Contrast Media; D007485:Ioxaglic Acid