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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2002-10-31
pubmed:abstractText
We performed a randomized, prospective, double blind trial comparing the use of the ionic dimer contrast agent ioxaglate 320 (Hexabrix) with the nonionic dimer contrast agent iodixanol 320 (Visipaque) in 618 patients undergoing percutaneous coronary intervention (PCI) for stable or unstable coronary artery syndromes. The aim was to determine whether the different anticoagulant and antiplatelet properties of these two contrast agents resulted in a significant difference in the incidence of a combined endpoint comprising the major complications of PCI. Procedural success rates were marginally higher in the Visipaque group compared to the Hexabrix group, although this did not reach statistical significance (96.7% vs. 93.9%; P = 0.09). There was a borderline statistically significant higher requirement for bailout stenting in the Visipaque group compared to the Hexabrix group (6.8% vs. 3.2%; P = 0.05), although this was not a predefined endpoint. The incidence of the combined primary endpoint of failed catheter laboratory outcome/requirement for bailout stenting/requirement for abciximab/myocardial infarction/death before hospital discharge was higher in the Visipaque group compared to the Hexabrix group (17.9% vs. 14.8%), although this did not reach statistical significance (P = 0.29). When subgroup analysis was performed, the incidence of the combined endpoint in patients with stable coronary artery disease randomized to receive either Visipaque or Hexabrix was identical (13.7%). In patients with an acute coronary syndrome, there was a trend toward a reduced incidence of the combined endpoint in the Hexabrix compared to the Visipaque group, although this did not reach statistical significance (17.2% vs. 24.8%; P = 0.17). More adverse reactions occurred in the Hexabrix group compared to the Visipaque group (8.7% vs. 4.9%; P = 0.06). We conclude that there is no clear advantage with the use of an ionic contrast agent in a large population of patients undergoing PCI for both stable and unstable coronary artery disease. Although the study was underpowered to detect significant differences with the use of either agent when patients with either stable or unstable coronary disease were studied, it is highly unlikely that the ionicity of the contrast agent confers any advantage for patients with stable coronary disease. There remains a possibility that ionic agents do have advantages for patients with unstable coronary artery disease undergoing PCI, although a larger study than ours would be required to confirm or refute this.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1522-1946
pubmed:author
pubmed:copyrightInfo
Copyright 2002 Wiley-Liss, Inc.
pubmed:issnType
Print
pubmed:volume
57
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
346-52
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed-meshheading:12410513-Adult, pubmed-meshheading:12410513-Aged, pubmed-meshheading:12410513-Aged, 80 and over, pubmed-meshheading:12410513-Angioplasty, Balloon, Coronary, pubmed-meshheading:12410513-Contrast Media, pubmed-meshheading:12410513-Double-Blind Method, pubmed-meshheading:12410513-Endpoint Determination, pubmed-meshheading:12410513-Female, pubmed-meshheading:12410513-Humans, pubmed-meshheading:12410513-Incidence, pubmed-meshheading:12410513-Ioxaglic Acid, pubmed-meshheading:12410513-Male, pubmed-meshheading:12410513-Middle Aged, pubmed-meshheading:12410513-Myocardial Ischemia, pubmed-meshheading:12410513-Postoperative Complications, pubmed-meshheading:12410513-Prospective Studies, pubmed-meshheading:12410513-Survival Analysis, pubmed-meshheading:12410513-Syndrome, pubmed-meshheading:12410513-Time Factors, pubmed-meshheading:12410513-Treatment Outcome, pubmed-meshheading:12410513-Triiodobenzoic Acids
pubmed:year
2002
pubmed:articleTitle
A randomized prospective trial of ioxaglate 320 (Hexabrix) vs. iodixanol 320 (Visipaque) in patients undergoing percutaneous coronary intervention.
pubmed:affiliation
Cardiothoracic Division, James Cook University Hospital, Middlesbrough, UK.
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Randomized Controlled Trial