One-year results of the ICON (Ionic versus non-ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) Study.
BACKGROUND
Long-term clinical outcomes after exposure to non-ionic iso-osmolar contrast medium (IOCM) or ionic low-osmolar CM (LOCM) in patients with chronic kidney disease (CKD) undergoing coronary angiography are unclear.


METHODS
The ICON trial was a prospective, double-blinded, multicentre study that randomly assigned 146 patients with CKD undergoing coronary angiography with or without percutaneous coronary intervention to the non-ionic IOCM Iodixanol or the ionic LOCM Ioxaglate. We report the 1-year clinical outcomes.


RESULTS
After randomization, baseline and procedural characteristics were well-matched between the two groups. At 1 year, three deaths (4.1%) occurred in the ioxaglate and nine deaths in the iodixanol group (13.6%, P = 0.07). The cardiac death rate at 1 year was 2.7% in the ioxaglate group and 9.1% in the iodixanol group (P = 0.07). There were no significant differences in the rates of myocardial infarction (1.4% vs. 1.5%; P = 1.00) and repeated revascularization (6.8% vs. 9.1%; P = 0.75).


CONCLUSIONS
The use of ionic LOCM ioxaglate was associated with a numerically lower mortality at 1 year as compared to iodixanol in patients who underwent cardiac catheterization. Future studies evaluating long-term safety following exposure to different types of CM are warranted.
Mount Sinai Medical Center, New York, New York.
Gennaro
G
Giustino
Mount Sinai Medical Center, New York, New York.
Usman
U
Baber
Mount Sinai Medical Center, New York, New York.
Ioannis
I
Mastoris
Mount Sinai Medical Center, New York, New York.
Georgios J
GJ
Vlachojannis
Mount Sinai Medical Center, New York, New York.
Jennifer
J
Yu
Scripps Clinic, San Diego, California.
Paul S
PS
Teirstein
Moses Cone Heart and Vascular Center, Greensboro, North Carolina.
William E
WE
Downey
St. Michaels Hospital, Toronto, Ontario, Canada.
Wayne B
WB
Batchelor
Swedish Heart and Vascular Institute, Seattle, Washington.
Peter J
PJ
Casterella
Cardiovascular Research Foundation, New York, New York.
Eugenia
E
Nikolsky
Department of Medicine, Weill-Cornell Medical College, New York, New York.
S Chiu
SC
Wong
Mount Sinai Medical Center, New York, New York.
Kleanthis N
KN
Theodoropoulos
Mount Sinai Medical Center, New York, New York.
George D
GD
Dangas
Mount Sinai Medical Center, New York, New York.
Roxana
R
Mehran
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007485:Ioxaglic Acid / Q000009:adverse effects* / Q000031:analogs & derivatives; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids / Q000009:adverse effects*
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol; D007485:Ioxaglic Acid
contrast media; contrast-induced nephropathy; iodixanol; ioxaglate; iso-osmolar; low-osmolar