In vivo effects of contrast media on coronary thrombolysis

Sorin Pislaru, Cristina D Pislaru, Monika Szilard, Jef Arnout, Frans Van De Werf

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives. The aim of the present study was to evaluate the influence of radiographic contrast media (CM) on alteplase-induced coronary thrombolysis. Background. Contrast media inhibit fibrinolysis in vitro and interact with endothelial cells, platelets and the coagulation system. The in vivo effects of CM on thrombolysis are not known. Methods. Occlusive coronary artery thrombosis was induced in 4 groups of 10 dogs by the copper coil technique. After 70 min of occlusion the dogs were randomized to intracoronary injection of 2 ml kg-1 of either saline, a low-osmolar ionic CM (ioxaglate), a low-osmolar nonionic CM (iohexol) or a high-osmolar ionic CM (amidotrizoate). Thrombolysis with alteplase and co-therapy With aspirin and heparin was initiated after 90 min of occlusion. The coronary artery flow was monitored with an electromagnetic flowmeter throughout the experiment. Results. Iohexol and amidotrizoate, but not ioxaglate, were associated with longer reperfusion delays (time to optimal reperfusion: 67 ± 48 min and 65 ± 49 min, respectively, vs. 21 ± 11 min after placebo; p < 0.05) and shorter periods of coronary perfusion (optimal perfusion time: 21 ± 26 min and 21 ± 28 min, respectively, vs. 58 ± 40 min after placebo; p < 0.05). No significant differences were observed between groups with regard to activated partial thromboplastin times, circulating thrombin-antithrombin III complex concentrations and fibrinogen. Conclusions. In this animal model administration of iohexol and amidotrizoate before thrombolysis significantly delayed reperfusion. This interaction should be considered in the design of clinical trials of thrombolytic therapy that evaluate coronary artery patency and in patients receiving local infusions of fibrinolytic agents.

Original languageEnglish (US)
Pages (from-to)1102-1108
Number of pages7
JournalJournal of the American College of Cardiology
Volume32
Issue number4
DOIs
StatePublished - Oct 1998
Externally publishedYes

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Contrast Media
Iohexol
Diatrizoate
Ioxaglic Acid
Reperfusion
Coronary Vessels
Tissue Plasminogen Activator
Perfusion
Placebos
Dogs
Coronary Thrombosis
Flowmeters
Fibrinolytic Agents
Partial Thromboplastin Time
Electromagnetic Phenomena
Thrombolytic Therapy
Fibrinolysis
Fibrinogen
Aspirin
Heparin

ASJC Scopus subject areas

  • Nursing(all)

Cite this

In vivo effects of contrast media on coronary thrombolysis. / Pislaru, Sorin; Pislaru, Cristina D; Szilard, Monika; Arnout, Jef; Van De Werf, Frans.

In: Journal of the American College of Cardiology, Vol. 32, No. 4, 10.1998, p. 1102-1108.

Research output: Contribution to journalArticle

Pislaru, Sorin ; Pislaru, Cristina D ; Szilard, Monika ; Arnout, Jef ; Van De Werf, Frans. / In vivo effects of contrast media on coronary thrombolysis. In: Journal of the American College of Cardiology. 1998 ; Vol. 32, No. 4. pp. 1102-1108.
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abstract = "Objectives. The aim of the present study was to evaluate the influence of radiographic contrast media (CM) on alteplase-induced coronary thrombolysis. Background. Contrast media inhibit fibrinolysis in vitro and interact with endothelial cells, platelets and the coagulation system. The in vivo effects of CM on thrombolysis are not known. Methods. Occlusive coronary artery thrombosis was induced in 4 groups of 10 dogs by the copper coil technique. After 70 min of occlusion the dogs were randomized to intracoronary injection of 2 ml kg-1 of either saline, a low-osmolar ionic CM (ioxaglate), a low-osmolar nonionic CM (iohexol) or a high-osmolar ionic CM (amidotrizoate). Thrombolysis with alteplase and co-therapy With aspirin and heparin was initiated after 90 min of occlusion. The coronary artery flow was monitored with an electromagnetic flowmeter throughout the experiment. Results. Iohexol and amidotrizoate, but not ioxaglate, were associated with longer reperfusion delays (time to optimal reperfusion: 67 ± 48 min and 65 ± 49 min, respectively, vs. 21 ± 11 min after placebo; p < 0.05) and shorter periods of coronary perfusion (optimal perfusion time: 21 ± 26 min and 21 ± 28 min, respectively, vs. 58 ± 40 min after placebo; p < 0.05). No significant differences were observed between groups with regard to activated partial thromboplastin times, circulating thrombin-antithrombin III complex concentrations and fibrinogen. Conclusions. In this animal model administration of iohexol and amidotrizoate before thrombolysis significantly delayed reperfusion. This interaction should be considered in the design of clinical trials of thrombolytic therapy that evaluate coronary artery patency and in patients receiving local infusions of fibrinolytic agents.",
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N2 - Objectives. The aim of the present study was to evaluate the influence of radiographic contrast media (CM) on alteplase-induced coronary thrombolysis. Background. Contrast media inhibit fibrinolysis in vitro and interact with endothelial cells, platelets and the coagulation system. The in vivo effects of CM on thrombolysis are not known. Methods. Occlusive coronary artery thrombosis was induced in 4 groups of 10 dogs by the copper coil technique. After 70 min of occlusion the dogs were randomized to intracoronary injection of 2 ml kg-1 of either saline, a low-osmolar ionic CM (ioxaglate), a low-osmolar nonionic CM (iohexol) or a high-osmolar ionic CM (amidotrizoate). Thrombolysis with alteplase and co-therapy With aspirin and heparin was initiated after 90 min of occlusion. The coronary artery flow was monitored with an electromagnetic flowmeter throughout the experiment. Results. Iohexol and amidotrizoate, but not ioxaglate, were associated with longer reperfusion delays (time to optimal reperfusion: 67 ± 48 min and 65 ± 49 min, respectively, vs. 21 ± 11 min after placebo; p < 0.05) and shorter periods of coronary perfusion (optimal perfusion time: 21 ± 26 min and 21 ± 28 min, respectively, vs. 58 ± 40 min after placebo; p < 0.05). No significant differences were observed between groups with regard to activated partial thromboplastin times, circulating thrombin-antithrombin III complex concentrations and fibrinogen. Conclusions. In this animal model administration of iohexol and amidotrizoate before thrombolysis significantly delayed reperfusion. This interaction should be considered in the design of clinical trials of thrombolytic therapy that evaluate coronary artery patency and in patients receiving local infusions of fibrinolytic agents.

AB - Objectives. The aim of the present study was to evaluate the influence of radiographic contrast media (CM) on alteplase-induced coronary thrombolysis. Background. Contrast media inhibit fibrinolysis in vitro and interact with endothelial cells, platelets and the coagulation system. The in vivo effects of CM on thrombolysis are not known. Methods. Occlusive coronary artery thrombosis was induced in 4 groups of 10 dogs by the copper coil technique. After 70 min of occlusion the dogs were randomized to intracoronary injection of 2 ml kg-1 of either saline, a low-osmolar ionic CM (ioxaglate), a low-osmolar nonionic CM (iohexol) or a high-osmolar ionic CM (amidotrizoate). Thrombolysis with alteplase and co-therapy With aspirin and heparin was initiated after 90 min of occlusion. The coronary artery flow was monitored with an electromagnetic flowmeter throughout the experiment. Results. Iohexol and amidotrizoate, but not ioxaglate, were associated with longer reperfusion delays (time to optimal reperfusion: 67 ± 48 min and 65 ± 49 min, respectively, vs. 21 ± 11 min after placebo; p < 0.05) and shorter periods of coronary perfusion (optimal perfusion time: 21 ± 26 min and 21 ± 28 min, respectively, vs. 58 ± 40 min after placebo; p < 0.05). No significant differences were observed between groups with regard to activated partial thromboplastin times, circulating thrombin-antithrombin III complex concentrations and fibrinogen. Conclusions. In this animal model administration of iohexol and amidotrizoate before thrombolysis significantly delayed reperfusion. This interaction should be considered in the design of clinical trials of thrombolytic therapy that evaluate coronary artery patency and in patients receiving local infusions of fibrinolytic agents.

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