One-year results of the ICON (ionic versus non-ionic contrast to obviate worsening nephropathy after angioplasty in chronic renal failure patients) Study

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Abstract

Background:

Long-term clinical outcomes after exposure to non-ionic iso-osmolar contrast medium (IOCM) or ionic low-osmolar CM (LOCM) in patients with chronic kidney disease (CKD) undergoing coronary angiography are unclear.

Methods:

The ICON trial was a prospective, double-blinded, multicentre study that randomly assigned 146 patients with CKD undergoing coronary angiography with or without percutaneous coronary intervention to the non-ionic IOCM Iodixanol or the ionic LOCM Ioxaglate. We report the 1-year clinical outcomes.

Results:

After randomization, baseline and procedural characteristics were well-matched between the two groups. At 1 year, three deaths (4.1%) occurred in the ioxaglate and nine deaths in the iodixanol group (13.6%,P= 0.07). The cardiac death rate at 1 year was 2.7% in the ioxaglate group and 9.1% in the iodixanol group (P= 0.07). There were no significant differences in the rates of myocardial infarction (1.4% vs. 1.5%;P= 1.00) and repeated revascularization (6.8% vs. 9.1%;P= 0.75).

Conclusions:

The use of ionic LOCM ioxaglate was associated with a numerically lower mortality at 1 year as compared to iodixanol in patients who underwent cardiac catheterization. Future studies evaluating long-term safety following exposure to different types of CM are warranted. © 2015 Wiley Periodicals, Inc.

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