title: β-Blocker premedication does not increase the frequency of allergic reactions from coronary CT angiography: Results from the Advanced Cardiovascular Imaging Consortium.
abstract: BACKGROUND
  β-Blockers are often used for heart rate control during coronary CT angiography (CTA). Increased frequency and severity of allergic reactions to radiocontrast media (RCM) have been reported with concomitant use of β-blockers.
  
  
  OBJECTIVE
  The objectives of this study were to determine whether there is a higher incidence of allergic reactions to low-osmolar nonionic RCM in patients undergoing coronary CTA with concomitant β-blockers and to define the overall incidence and severity of allergic reactions in patients undergoing coronary CTA with and without a history of allergy to RCM.
  
  
  METHODS
  Patients undergoing coronary CTA at 47 institutions participating in the Advanced Cardiovascular Imaging Consortium registry were analyzed. The incidence and severity of allergic reactions were compared between those patients who did and those who did not receive β-blockers, as well as in subgroups of patients with and without a history of prior allergy to RCM.
  
  
  RESULTS
  The incidence of allergic reaction in patients who received β-blockers was 45 of 23,867 (0.19%) compared with those who did not receive β-blockers, which was 9 of 5232 (0.17%; P = .84; odds ratio = 1.1). Of the patients with history of allergy to RCM, 4 of 706 patients (0.6%) on β-blockers experienced allergic reactions compared to 1 of 77 patients (1.3%) without β-blockers (P = .40; odds ratio = 0.43).
  
  
  CONCLUSIONS
  β-Blocker pretreatment had no effect on the frequency or severity of allergic reaction in patients undergoing coronary CTA, even in patients with a past history of allergy to RCM.
authors.affiliation: Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA.
authors.forename: Anshul
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Smith
authors.affiliation: Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA; Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
authors.forename: Kavitha M
authors.initials: KM
authors.lastname: Chinnaiyan
authors.affiliation: Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA.
authors.forename: Neesurg
authors.initials: N
authors.lastname: Mehta
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Beaumont Health Research Institute, Royal Oak, MI, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Boura
authors.affiliation: Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA.
authors.forename: Rami
authors.initials: R
authors.lastname: Khoury Abdulla
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Section of Allergy and Immunology, Department of Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA.
authors.forename: Carl B
authors.initials: CB
authors.lastname: Lauter
authors.affiliation: Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA; Oakland University William Beaumont School of Medicine, Rochester, MI, USA. Electronic address: GRaff@beaumont.edu.
authors.forename: Gilbert L
authors.initials: GL
authors.lastname: Raff
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects / Q000706:statistics & numerical data*; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D004357:Drug Synergism; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011292:Premedication / Q000009:adverse effects / Q000706:statistics & numerical data*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D003287:Contrast Media
keywords: Anaphylaxis; Contrast allergy; Coronary CTA; Radiocontrast media; β-Blockers