The effects of iodixanol and iopamidol on adhesion molecule serum levels in patients with angina pectoris undergoing coronary angiography: a randomized study.
OBJECTIVE
To compare intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) serum levels between patients with stable (SAP) and unstable angina pectoris (USAP) undergoing coronary angiography (CAG), investigate effects of CAG on ICAM-1, VCAM-1 levels in SAP, USAP patients; probable different effects of non-ionic radiocontrast media (RCM), iso-osmotic iodixanol and low osmolar iopamidol, on these adhesion molecules (AM).


METHODS
In this randomized, prospective study, 2 groups consisting of patients with SAP (n=22) and USAP (n=22) undergoing CAG were included. For halves of each group iopamidol, for the other halves iodixanol were used as RCM, in turn for randomization. The patients were divided into 4 subgroups according to clinical presentations and used RCM(SAP-iodixanol, SAP-iopamidol USAP-iodixanol, USAP-iopamidol). ICAM-1, VCAM-1 levels were measured just before and 12 hours after CAG. Repeated measurements were compared with two-way ANOVA test.


RESULTS
Baseline VCAM-1 concentration was higher in USAP group than SAP group (p=0.001). ICAM-1, VCAM-1 concentrations increased significantly following CAG in SAP, USAP groups. ICAM-1, VCAM-1 concentration increments; didn't reach statistical significance in SAP-iodixanol subgroup, reached a borderline significance in SAP-iopamidol subgroup (p=0.06). In USAP-iodixanol subgroup; only VCAM-1 (p<0.001), in USAP-iopamidol subgroup; ICAM-1 (p=0.009), VCAM-1 (p=0.006) levels increased significantly following CAG. No complication was observed.


CONCLUSIONS
To our knowledge, this is the first study indicating ICAM-1, VCAM-1 inducing effect of CAG in patients with SAP, USAP and differential effects of iodixanol and iopamidol on ICAM-1, VCAM-1 serum levels. Further studies are needed to clarify the effects of CAG and different RCM on vascular inflammation, vessel injury, serum AM levels and their clinical significance. This study should be taken as a pilot, hypothesis-generating study.
Clinic of Cardiology, Anamur State Hospital; Mersin-Turkey. drfilizkrd@hotmail.com.
Filiz
F
Akyıldız Akçay
Serdar
S
Bayata
Tuna
T
Semerci
Murat
M
Yeşil
Oğuzhan
O
Toklu
Erdinç
E
Arıkan
Selcen
S
Yakar Tülüce
Mehmet
M
Köseoğlu
Idil
I
Koçağra Yağız
D000787:Angina Pectoris / Q000209:etiology*; D003287:Contrast Media / Q000494:pharmacology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood / Q000187:drug effects; D007479:Iopamidol / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014283:Triiodobenzoic Acids / Q000494:pharmacology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood / Q000187:drug effects
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; C044834:iodixanol; D007479:Iopamidol