Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic, electrocardiographic, and clinical outcomes following thrombolytic administration in acute myocardial infarction

C. Michael Gibson, Ajay J. Kirtane, Sabina A. Murphy, Susan J. Marble, James A de Lemos, Elliot M. Antman, Eugene Braunwald

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The goal of this study was to examine the relationship between contrast agent type (ionic vs. nonionic) and angiographic, electrocardiographic, and clinical outcomes after thrombolytic administration. Ionic or nonionic contrast agents were selected in a nonrandomized fashion for 90-min angiography and percutaneous coronary intervention (PCI) following thrombolytic administration in the TIMI 14 trial [tissue plasminogen activator (tPA) or reteplase (rPA) vs. low-dose lytic + abciximab]. There was no relationship between contrast agent type and overall patency, rate of TIMI grade 3 flow, or corrected TIMI frame counts (CTFCs) in open culprit arteries and in post-PCI patency rates or post-PCI CTFCs. In patients treated with ionic contrast, ejection fractions at 90 min were slightly but significantly lower (56.2 ± 16.5, n = 122, vs. 59.8 ± 14.4, n = 322; P = 0.02), chest pain duration was longer (2.8 ± 4.1 hr, n = 255, vs. 1.7 ± 3.6, n = 550; P = 0.0003), and complete ST segment resolution was less frequent (41.5% vs. 50.8%; P = 0.04). While there was no difference in epicardial blood flow, ionic contrast agent use was associated with poorer ST segment resolution, longer chest pain duration, and poorer ejection fractions, perhaps as a result of microvascular dysfunction.

Original languageEnglish (US)
Pages (from-to)6-11
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume53
Issue number1
DOIs
StatePublished - 2001

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Coronary Angiography
Contrast Media
Percutaneous Coronary Intervention
Myocardial Infarction
Chest Pain
Tissue Plasminogen Activator
Angiography
Arteries

Keywords

  • Acute myocardial infarction
  • Angiography
  • Contrast agent
  • Coronary blood flow
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic, electrocardiographic, and clinical outcomes following thrombolytic administration in acute myocardial infarction. / Michael Gibson, C.; Kirtane, Ajay J.; Murphy, Sabina A.; Marble, Susan J.; de Lemos, James A; Antman, Elliot M.; Braunwald, Eugene.

In: Catheterization and Cardiovascular Interventions, Vol. 53, No. 1, 2001, p. 6-11.

Research output: Contribution to journalArticle

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abstract = "The goal of this study was to examine the relationship between contrast agent type (ionic vs. nonionic) and angiographic, electrocardiographic, and clinical outcomes after thrombolytic administration. Ionic or nonionic contrast agents were selected in a nonrandomized fashion for 90-min angiography and percutaneous coronary intervention (PCI) following thrombolytic administration in the TIMI 14 trial [tissue plasminogen activator (tPA) or reteplase (rPA) vs. low-dose lytic + abciximab]. There was no relationship between contrast agent type and overall patency, rate of TIMI grade 3 flow, or corrected TIMI frame counts (CTFCs) in open culprit arteries and in post-PCI patency rates or post-PCI CTFCs. In patients treated with ionic contrast, ejection fractions at 90 min were slightly but significantly lower (56.2 ± 16.5, n = 122, vs. 59.8 ± 14.4, n = 322; P = 0.02), chest pain duration was longer (2.8 ± 4.1 hr, n = 255, vs. 1.7 ± 3.6, n = 550; P = 0.0003), and complete ST segment resolution was less frequent (41.5{\%} vs. 50.8{\%}; P = 0.04). While there was no difference in epicardial blood flow, ionic contrast agent use was associated with poorer ST segment resolution, longer chest pain duration, and poorer ejection fractions, perhaps as a result of microvascular dysfunction.",
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AB - The goal of this study was to examine the relationship between contrast agent type (ionic vs. nonionic) and angiographic, electrocardiographic, and clinical outcomes after thrombolytic administration. Ionic or nonionic contrast agents were selected in a nonrandomized fashion for 90-min angiography and percutaneous coronary intervention (PCI) following thrombolytic administration in the TIMI 14 trial [tissue plasminogen activator (tPA) or reteplase (rPA) vs. low-dose lytic + abciximab]. There was no relationship between contrast agent type and overall patency, rate of TIMI grade 3 flow, or corrected TIMI frame counts (CTFCs) in open culprit arteries and in post-PCI patency rates or post-PCI CTFCs. In patients treated with ionic contrast, ejection fractions at 90 min were slightly but significantly lower (56.2 ± 16.5, n = 122, vs. 59.8 ± 14.4, n = 322; P = 0.02), chest pain duration was longer (2.8 ± 4.1 hr, n = 255, vs. 1.7 ± 3.6, n = 550; P = 0.0003), and complete ST segment resolution was less frequent (41.5% vs. 50.8%; P = 0.04). While there was no difference in epicardial blood flow, ionic contrast agent use was associated with poorer ST segment resolution, longer chest pain duration, and poorer ejection fractions, perhaps as a result of microvascular dysfunction.

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