Effect of iodixanol and ioxilan on QT interval and renal function in patients with systolic heart failure.
BACKGROUND
Contrast media (CM) exposure is associated with a substantial risk of arrhythmias and nephrotoxicity. These adverse effects may be exacerbated in high-risk conditions such as heart failure, although no studies have evaluated newer CM agents in this population. This study evaluated the electrophysiologic and renal effects of two newer CM agents, iodixanol and ioxilan, in heart failure patients undergoing angiography.


METHODS
Eighty-seven consecutive systolic heart failure patients who received either iso-osmolar iodixanol (n=44) or low-osmolar ioxilan (n=43), stratified for concomitant amiodarone, were evaluated for QT interval and serum creatinine changes in comparison to baseline. QT values were corrected according to three formulae: Bazett's correction, Fridericia formula, and Framingham equation.


RESULTS
Baseline patient characteristics were not significantly different in the iodixanol versus ioxilan groups, except for myocardial infarction and renal disease. No significant change in mean QTc was observed after exposure to either CM agent compared to baseline. These results were unaffected by amiodarone. A significant improvement in serum creatinine from baseline was observed in the iodixanol group compared to the ioxilan group (-0.121 ± 0.35 mg/dL vs. 0.033 ± 0.23 mg/dL, respectively; p=0.045).


CONCLUSIONS
No significant change in QTc interval was observed in patients receiving either iodixanol or ioxilan during angiography. Iodixanol appeared to improve short-term renal function in patients with heart failure and should be further investigated.
Chow
Sheryl L
SL
Western University of Health Sciences, College of Pharmacy, Pomona, CA 91766, United States. SChow@westernu.edu
Ng
Tien M H
TM
Litwinski
Roman A
RA
Kangavari
Simon
S
Weiss
Mason
M
D000368:Aged; D003287:Contrast Media / Q000494:pharmacology*; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives* / Q000494:pharmacology; D007668:Kidney / Q000187:drug effects* / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D014283:Triiodobenzoic Acids / Q000494:pharmacology*
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; C055357:ioxilan; D003404:Creatinine; C044834:iodixanol