title: Coronary computed tomography angiography - tolerability of β-blockers and contrast media, and temporal changes in radiation dose.
abstract: OBJECTIVE
  To determine the risk in administering β-blockers, contrast-induced nephropathy (CIN) and the trend in X-ray use, during coronary computed tomography angiography (CCTA).
  
  
  METHODS
  A total of 416 patients were referred for elective CCTA. To achieve a resting heart rate below 60 beats per minute, oral and/or intravenous β-blockers were administered. Using questionnaires, information on the adverse effects of β-blockers was collected from the patients. The levels of s-creatinine and estimated GFR (eGFR) were measured before and after contrast enhanced CCTA. Radiation exposure was compared with the exposure 3 years earlier.
  
  
  RESULTS
  There was no significant difference in the symptoms (dizziness, lipothymia and palpitations) between patients with and patients without β-blocker pretreatment. Compared to baseline values, the decrease in s-creatinine was not significant (75.2 vs. 74.6 μmol/L, p = 0.09), while the increase in eGFR was not significant (78 vs. 79 mL/min, p = 0.17). Also, subgroups of patients with hypertension, hypercholesterolemia, diabetes or pre-existing slight impairment in renal function did not develop CIN. The mean radiation exposure decreased from 17.5 to 6.7 mSv, p < 0.0001.
  
  
  CONCLUSIONS
  In terms of the side effects of β-blockers and contrast media, there were no short term complications to CCTA. Furthermore, the radiation dose has been dramatically diminished over the last three years.
authors.affiliation: Department of Cardiology, Odense University Hospital , Odense C , Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Pedersen
authors.forename: Camilla F
authors.initials: CF
authors.lastname: Thomsen
authors.forename: Susanne E
authors.initials: SE
authors.lastname: Hosbond
authors.forename: Anders
authors.initials: A
authors.lastname: Thomassen
authors.forename: Hans
authors.initials: H
authors.lastname: Mickley
authors.forename: Axel C P
authors.initials: AC
authors.lastname: Diederichsen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography / Q000379:methods*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed
chemical_list: D000319:Adrenergic beta-Antagonists; D003287:Contrast Media; D003404:Creatinine
keywords: adverse effects; beta-blockers; cardiac CT; complications; contrast nephropathy; coronary computed tomography angiography; radiation exposure