title: Long-Term Adverse Effects of Low-Osmolar Compared With Iso-Osmolar Contrast Media After Coronary Angiography.
abstract: The relative incidence of long-term adverse effects between low-osmolar contrast media (LOCM) and iso-osmolar contrast media (IOCM) after coronary angiography is still unclear. We analyzed cardiology patients undergoing coronary angiography from January 2006 to July 2013 using either LOCM (iohexol, iopromide) or IOCM (iodixanol) at a single institution. For each contrast medium, primary (all-cause mortality, n = 6,992) and secondary outcomes (long-term renal injury and cardiovascular events beyond 90 days, n = 2,792) were recorded. Inverse probability weighing (IPW) was applied to minimize the selection bias between groups. Unadjusted all-cause mortality was significantly lower for LOCM versus IOCM (hazard ratio [HR] 0.28, 95% CI 0.23 to 0.34). After multivariate Cox regression or IPW, all-cause mortality became comparable and lost statistical significance. Chronic kidney disease subgroup had higher mortality risk when receiving LOCM compared with IOCM (regression adjusted HR 1.80, 95% CI 0.95 to 3.42; IPW-adjusted HR 1.57, 95% CI 0.99 to 2.48). In conclusion, after coronary angiography, patients receiving LOCM had comparable overall long-term mortality compared with IOCM after adjustment. LOCM tended to induce higher long-term mortality than IOCM in chronic kidney disease cohorts.
authors: Department of Radiology, Jiangsu Key Laboratory of Molecular and Functional Imaging, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
authors: Yuan-Cheng
authors: YC
authors: Wang
authors: Department of Radiology, Macclesfield District General Hospital, Victoria Road, Macclesfield, Cheshire, United Kingdom.
authors: Adrian
authors: A
authors: Tang
authors: Department of Radiology, Jiangsu Key Laboratory of Molecular and Functional Imaging, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
authors: Di
authors: D
authors: Chang
authors: Department of Radiology, Jiangsu Key Laboratory of Molecular and Functional Imaging, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
authors: Chun-Qiang
authors: CQ
authors: Lu
authors: Department of Radiology, Jiangsu Key Laboratory of Molecular and Functional Imaging, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
authors: Shi-Jun
authors: SJ
authors: Zhang
authors: Department of Radiology, Jiangsu Key Laboratory of Molecular and Functional Imaging, Zhongda Hospital, Medical School, Southeast University, Nanjing, China. Electronic address: jsh0836@hotmail.com.
authors: Shenghong
authors: S
authors: Ju
mesh_terms: D000368:Aged; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D003287:Contrast Media; D017023:Coronary Angiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007472:Iohexol / Q000031:analogs & derivatives; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D009994:Osmolar Concentration; D057216:Propensity Score; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; C038192:iopromide; C044834:iodixanol