Radiographic Contrast 1999-2001

AVAILABLE FOR SELF-PACED LEARNING
Iodinated contrast media: minimizing thrombosis and nephropathy
http://www.theheart.org/index.cfm?doc_id=23430  
Drs Wayne B Batchelor and Roxana Mehran explore the differences between ionic and nonionic contrast media in the context of percutaneous coronary intervention. This continuing medical education activity provides an in-depth examination of the COURT trial, emphasizing the limitations of that trial. The program also focuses on GP IIb/IIIa inhibitors and contrast media as they affect thrombus generation
(CME credit: 2 hours, category 1).
[Supported by an educational grant from Tyco Healthcare — Mallinckrodt Inc]

Editorial
Prevention of contrast nephropathy after cardiac catheterisation
C S R BAKER and L R I BAKER
Heart 2001;85 361-362
http://www.heartjnl.com/cgi/content/full/85/4/361

AVAILABLE FOR SELF-PACED LEARNING
"Critical issues in the choice of contrast media in PTCA"
Originally presented in May 1999; now available as a CME activity. Dr Gilbert Deray and an international faculty provide an in-depth examination of contrast agents as they relate to thrombotic complications during coronary angiography (CME credit: 2 hours, category 1). 
Find it at: http://www.theheart.org/index.cfm?doc_id=21354
[supported by an unrestricted educational grant from Mallinckrodt Medical]

Effectiveness of and adverse events after percutaneous coronary intervention in patients with mild versus severe renal failure
Rubenstein MH, et al.
Am J Cardiol 2001;87:856-60.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11274940

Acute renal failure requiring dialysis after percutaneous coronary interventions
Gruberg L, et al.
Catheter Cardiovasc Interv 2001;52:409-16.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11285590

AHA 2000 Meeting Coverage

CME Cybersession
Optimizing the choice of contrast agent in coronary angiography 
http://cme.cybersessions.org/dukeu-port11oct00/index.html 
October 11, 2000
Drs James Tcheng (chair), Roxana Mehran, and Gilbert Deray discuss how to properly select a contrast agent in the cath lab and how to minimize the risks of contrast administration during angiography.

Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine
 
Tepel M et al.
  N Engl J Med 2000;343:180-4
  http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010900277
Prophylactic oral administration of the antioxidant acetylcysteine (600 mg orally twice daily) and 0.45 percent saline intravenously, before and after administration of the contrast agent prevent the reduction in renal function induced by contrast agents in patients with chronic renal insufficiency.

VIP Trial - Influence of a nonionic, iso-osmolar contrast medium (iodixanol) versus an ionic, low-osmolar contrast medium (ioxaglate) on major adverse cardiac events in patients undergoing percutaneous transluminal coronary angioplasty: A multicenter, randomized, double-blind study. Visipaque in Percutaneous Transluminal Coronary Angioplasty
  Bertrand ME et al.
  Circulation 2000;101:131-6
  http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010637198
No significant differences were observed between the iodixanol and ioxaglate groups with regard to MACE, although hypersensitivity and adverse drug reactions were significantly less frequent in patients who received iodixanol.

COURT trial - Randomized trial of contrast media utilization in high-risk PTCA
 
Davidson CJ et al.
  Circulation 2000;101:2172-7
  http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010801758
In this contemporary prospective multicenter trial of PTCA in the setting of acute coronary syndromes, there was a low incidence of in-hospital clinical events for both treatment groups. The cohort receiving the nonionic dimer iodixanol experienced a 45% reduction in in-hospital MACE when compared with the cohort receiving ioxaglate.

The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre- existent chronic renal insufficiency
Gruberg L, et al.
J Am Coll Cardiol 2000;36:1542-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11079656

Effects of dopamine and aminophylline on contrast-induced acute renal failure after coronary angioplasty in patients with preexisting renal insufficiency
Abizaid AS, et al.
Am J Cardiol 1999;83:260-3, A5.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10073832