Changes in endothelial, leucocyte and platelet markers following contrast medium injection during angiography in patients with peripheral artery disease.
Peripheral artery angiography, a common diagnostic procedure, may cause early and late adverse reactions, such as anaphylaxis, thrombosis and possible progression of the underlying arterial disease. To test the hypothesis that radiographic contrast medium may contribute to these events by adversely affecting the endothelium, leucocytes and/or platelets, 19 subjects undergoing angiography for the investigation and/or treatment of lower limb atherosclerosis were recruited. Blood was obtained from the external iliac vein before, and at serial intervals after, the injection of radiographic contrast medium into the ipsilateral femoral artery for diagnostic use. Markers of endothelial cell injury (von Willebrand factor (vWf)), platelet activation (soluble P-selectin) and leucocyte activation (neutrophil elastase and soluble L-selectin) were measured in citrated plasma. Soluble intercellular adhesion molecule-1 (sICAM-1) and thromboxane B(2), which are non-specific markers of inflammation, were also measured. Compared with the sample prior to angiography, levels of soluble L-selectin and sICAM-1 were reduced (p<0.02) immediately after passage of the last bolus of contrast medium. 15 min later, levels returned to normal but the level of vWf had increased (p<0.02). After 30 min, only levels of thromboxane B(2) were increased (p<0.05). The following day both vWf (p<0.01) and soluble P-selectin (p<0.05) were increased. These data point to both early and late effects of contrast medium on markers of endothelial, platelet and leucocyte function.
Blann
A D
AD
Department of Surgery, South Manchester University Hospital, Nell Lane, Manchester M20 8LR, UK.
Adams
R
R
Ashleigh
R
R
Naser
S
S
Kirkpatrick
U
U
McCollum
C N
CN
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000187:drug effects*; D003287:Contrast Media / Q000494:pharmacology*; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007472:Iohexol / Q000494:pharmacology; D007866:Leg / Q000098:blood supply; D007962:Leukocytes / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010196:Pancreatic Elastase / Q000097:blood; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D011859:Radiography; D013929:Thromboxane B2 / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D003287:Contrast Media; D019007:P-Selectin; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D007472:Iohexol; D013929:Thromboxane B2; D010196:Pancreatic Elastase