The relative renal safety of iodixanol and low-osmolar contrast media in patients undergoing percutaneous coronary intervention. Insights from blue cross blue shield of Michigan cardiovascular consortium (BMC2)

Michael C. Reed, Mauro Moscucci, Dean E. Smith, David Share, Thomas Lalonde, Syed A. Mahmood, Chris D'Haem, Richard McNamara, Adam Greenbaum, Hitinder S. Gurm

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a common complication of percutaneous coronary intervention (PCI). Current guidelines support the use of iodixanol (Visipaque®, GE Healthcare, Princeton, New Jersey) in patients at high risk for CI-AKI. Recent trials and meta-analyses have shown no difference in CI-AKI when iodixanol is compared to low-osmolar contrast media (LOCM). We evaluated the incidence of CI-AKI, in-hospital dialysis and in-hospital death in 58,957 patients who underwent PCI in 2007 and 2008 in a large regional consortium of 31 hospitals and who were treated with iodixanol (n ≤ 17,814) or LOCM (n ≤ 41,143). Propensity-matched analysis was performed to adjust for differences in baseline variables. Patients treated with iodixanol compared to those treated with LOCM were slightly older, had more medical comorbidities and a higher baseline creatinine (1.35 ± 1.07 mg/dL versus 1.10 ± 0.85 mg/dL; p < 0.0001). In propensity-matched, risk-adjusted models, there was no significant difference between iodixanol and LOCM in the risk of CIAKI (4.54 vs. 4.14; p ≤ 0.14), need for dialysis (0.37 vs. 0.43; p ≤ 0.35) or death (1.46 vs. 1.39; p ≤ 0.18). Among patients undergoing PCI, the use of iodixanol was more frequent in older patients with more comorbidities and worse baseline renal function. There was no difference in the adjusted risk of CI-AKI among patients treated with iodixanol compared with those treated with LOCM.

Original languageEnglish
Pages (from-to)467-472
Number of pages6
JournalJournal of Invasive Cardiology
Volume22
Issue number10
StatePublished - Oct 1 2010

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Blue Cross Blue Shield Insurance Plans
Percutaneous Coronary Intervention
Contrast Media
Kidney
Safety
Acute Kidney Injury
Comorbidity
Dialysis
iodixanol
Meta-Analysis
Creatinine
Guidelines
Delivery of Health Care

Keywords

  • contrast media
  • contrast-induced nephropathy
  • iodixanol
  • low-osmolar contrast media

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

The relative renal safety of iodixanol and low-osmolar contrast media in patients undergoing percutaneous coronary intervention. Insights from blue cross blue shield of Michigan cardiovascular consortium (BMC2). / Reed, Michael C.; Moscucci, Mauro; Smith, Dean E.; Share, David; Lalonde, Thomas; Mahmood, Syed A.; D'Haem, Chris; McNamara, Richard; Greenbaum, Adam; Gurm, Hitinder S.

In: Journal of Invasive Cardiology, Vol. 22, No. 10, 01.10.2010, p. 467-472.

Research output: Contribution to journalArticle

Reed, Michael C. ; Moscucci, Mauro ; Smith, Dean E. ; Share, David ; Lalonde, Thomas ; Mahmood, Syed A. ; D'Haem, Chris ; McNamara, Richard ; Greenbaum, Adam ; Gurm, Hitinder S. / The relative renal safety of iodixanol and low-osmolar contrast media in patients undergoing percutaneous coronary intervention. Insights from blue cross blue shield of Michigan cardiovascular consortium (BMC2). In: Journal of Invasive Cardiology. 2010 ; Vol. 22, No. 10. pp. 467-472.
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