Key result
Diagnostic coronary angiography with low-osmolar iopamidol significantly increased both ICAM-1 and VCAM-1 levels in unstable angina patients, whereas iso-osmolar iodixanol only significantly increased VCAM-1.
Why the study?
Does the choice of radiocontrast media (iodixanol vs iopamidol) affect serum levels of ICAM-1 and VCAM-1 in patients with stable or unstable angina undergoing coronary angiography?
RCT (n=44)
in turn for randomization
No
Does the choice of radiocontrast media (iodixanol vs iopamidol) affect serum levels of ICAM-1 and VCAM-1 in patients with stable or unstable angina undergoing coronary angiography?
Answers are grounded in this paper and cite their sources.
Low-osmolar iopamidol may induce a greater release of inflammatory adhesion molecules compared to iso-osmolar iodixanol during coronary angiography, particularly in patients with unstable angina.
OBJECTIVE: To compare intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) serum levels between patients with stable (SAP) and unstable angina pectoris (USAP) undergoing coronary angiography (CAG), investigate effects of CAG on ICAM-1, VCAM-1 levels in SAP, USAP patients; probable different effects of non-ionic radiocontrast media (RCM), iso-osmotic iodixanol and low osmolar iopamidol, on these adhesion molecules (AM). METHODS: In this randomized, prospective study, 2 groups consisting of patients with SAP (n=22) and USAP (n=22) undergoing CAG were included. For halves of each group iopamidol, for the other halves iodixanol were used as RCM, in turn for randomization. The patients were divided into 4 subgroups according to clinical presentations and used RCM(SAP-iodixanol, SAP-iopamidol USAP-iodixanol, USAP-iopamidol). ICAM-1, VCAM-1 levels were measured just before and 12 hours after CAG. Repeated measurements were compared with two-way ANOVA test. RESULTS: Baseline VCAM-1 concentration was higher in USAP group than SAP group (p=0.001). ICAM-1, VCAM-1 concentrations increased significantly following CAG in SAP, USAP groups. ICAM-1, VCAM-1 concentration increments; didn't reach statistical significance in SAP-iodixanol subgroup, reached a borderline significance in SAP-iopamidol subgroup (p=0.06). In USAP-iodixanol subgroup; only VCAM-1 (p<0.001), in USAP-iopamidol subgroup; ICAM-1 (p=0.009), VCAM-1 (p=0.006) levels increased significantly following CAG. No complication was observed. CONCLUSION: To our knowledge, this is the first study indicating ICAM-1, VCAM-1 inducing effect of CAG in patients with SAP, USAP and differential effects of iodixanol and iopamidol on ICAM-1, VCAM-1 serum levels. Further studies are needed to clarify the effects of CAG and different RCM on vascular inflammation, vessel injury, serum AM levels and their clinical significance. This study should be taken as a pilot, hypothesis-generating study.
No takes yet. Share an insight, caveat, or question.
Akçay et al. (2014) conducted an RCT in Stable and unstable angina pectoris (n=44). Iodixanol vs. Iopamidol was evaluated on Change in ICAM-1 and VCAM-1 serum levels 12 hours after coronary angiography. Diagnostic coronary angiography with low-osmolar iopamidol significantly increased both ICAM-1 and VCAM-1 levels in unstable angina patients, whereas iso-osmolar iodixanol only significantly increased VCAM-1.
Synapse has enriched 10 related papers. Consider them for comparative context: