Within-Hospital and 30-Day Outcomes in 107,994 Patients Undergoing Invasive Coronary Angiography With Different Low-Osmolar Iodinated Contrast Media

• Published in: The American journal of cardiology 2012-06, Vol.109 (11), p.1594-1599
• Main Authors: LaBounty, Troy M., MD, Shah, Manan, PharmD, PhD, Raman, Subha V., MD, Lin, Fay Y., MD, Berman, Daniel S., MD, Min, James K., MD
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - therapy; Aged; Cardiology; Cardiovascular; Cardiovascular disease; Clinical outcomes; Contrast Media - adverse effects; Coronary Angiography - methods; Databases, Factual; Female; Hospital Mortality; Humans; Iohexol - adverse effects; Iopamidol - adverse effects; Length of Stay - statistics & numerical data; Male; Medical imaging; Medical treatment; Mortality; Patient Readmission - statistics & numerical data; Propensity Score; Renal Dialysis - statistics & numerical data; Retrospective Studies; Triiodobenzoic Acids - adverse effects; United States - epidemiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2012.01.380

Comparative clinical outcomes after exposure to alternate low osmolar contrast media (LOCM) during invasive coronary angiography (ICA) and/or percutaneous coronary intervention (PCI) have been incompletely examined. From a retrospective multicenter observational study, we identified 107,994 adults without previous hemodialysis undergoing ICA and/or PCI with iohexol, iopamidol, or ioversol. We created a propensity score for contrast media type using age, gender, coverage status, route of hospitalization, illness severity, physician specialty, co-morbidities, and procedure type. Propensity matching was performed in a 1:1 fashion for iohexol (n = 10,204) and iopamidol (n = 10,204) and in a 1:1 fashion for iohexol (n = 19,482) and ioversol (n = 19,482). Groups were examined for differences in in-hospital mortality or subsequent hemodialysis, length of stay, and 30-day readmission for contrast-induced nephropathy (CIN). Compared to patients exposed to iohexol, no differences were observed for patients exposed to iopamidol or ioversol for in-hospital hemodialysis (0.5% vs 0.4%, p = 0.45; 0.3% vs 0.5%, p = 0.05), in-hospital mortality (0.7% vs 0.6%, p = 0.60; 0.5% vs 0.6%, p = 0.42), or composite hemodialysis or mortality (1.1% vs 1.0%, p = 0.58; 0.8% vs 1.0%, p = 0.06); for hospital length of stay (2.9 ± 2.7 vs 2.9 ± 2.7 days, p = 0.05; 2.8 ± 2.6 vs 2.9 ± 3.1 days, p = 0.35); or for 30-day readmission for CIN (0.1% vs 0.1%, p = 0.82; 0.1% vs 0.1%, p = 0.52). In conclusion, for patients undergoing ICA and/or PCI exposed to alternate LOCM, in-hospital death, need for hemodialysis, or readmission for CIN are uncommon, with no apparent clinical advantage among LOCM agents.