title: Acute adverse reactions to gadolinium-based contrast agents in CMR: multicenter experience with 17,767 patients from the EuroCMR Registry.
abstract: OBJECTIVE
  The purpose of this study was to assess the frequency, manifestation, and severity of acute adverse reactions associated with administration of several gadolinium-based contrast agents to patients who underwent cardiac magnetic resonance (CMR) imaging in the EuroCMR (European Cardiovascular Magnetic Resonance) Registry multinational and multicenter setting.
  
  
  BACKGROUND
  The frequency, manifestations, and severity of acute adverse reactions associated with gadolinium-based contrast agents in the specific setting of cardiovascular magnetic resonance have not been systematically evaluated yet.
  
  
  METHODS
  This is a multicenter and multinational registry with consecutive enrollment of patients in 45 European centers. During the current observation, 17,767 doses of gadolinium-based contrast agent were administered to 17,767 patients. The mean dose was 25.6 ml (range 5 to 80 ml), which is equivalent to 0.128 mmol/kg (range 0.012 to 0.3 mmol/kg).
  
  
  RESULTS
  Thirty acute adverse reactions due to contrast administration occurred (0.17%). All reactions were classified as mild according to the American College of Radiology definition. The most frequent complaints following contrast administration were rashes and hives (9 of 30), followed by nausea (7 of 30), and anxiety (6 of 30). The event rate ranged from 0.06% (linear nonionic agent gadodiamide) to 0.47% (linear ionic agent gadobenate dimeglumine). Interestingly, we also found different event rates between the three main indications for CMR imaging, ranging from 0.1% (risk stratification in suspected coronary artery disease) to 0.42% (viability in known coronary artery disease).
  
  
  CONCLUSIONS
  The incidence of acute adverse reactions after administration of gadolinium-based contrast in the "off-label" setting of CMR in our population was not different from the incidence in the U.S. Food and Drug Administration-approved general radiology setting. Thus, the off-label use of gadolinium-based contrast in CMR should be regarded as safe concerning the frequency, manifestation, and severity of acute events.
authors.affiliation: Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bruder
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.forename: Detlev
authors.initials: D
authors.lastname: Nothnagel
authors.forename: Günter
authors.initials: G
authors.lastname: Pilz
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.forename: Anil
authors.initials: A
authors.lastname: Sinha
authors.forename: Anja
authors.initials: A
authors.lastname: Wagner
authors.forename: Thorsten
authors.initials: T
authors.lastname: Dill
authors.forename: Herbert
authors.initials: H
authors.lastname: Frank
authors.forename: Albert
authors.initials: A
authors.lastname: van Rossum
authors.forename: Jürg
authors.initials: J
authors.lastname: Schwitter
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Georg
authors.initials: G
authors.lastname: Sabin
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
authors.forename: Heiko
authors.initials: H
authors.lastname: Mahrholdt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005060:Europe; D005260:Female; D005682:Gadolinium / Q000009:adverse effects*; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium