Iodinated Contrast Media Allergy in Patients Hospitalized for Investigation of Chest Pain

Guy Topaz, Adi Karas, Nuha Kassem, Yona Kitay-Cohen, David Pereg, Lotan Shilo, Adi Zoref-Lorenz, Alon Y. Hershko

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Iodinated contrast media (ICM) allergy may entail severe adverse events in patients who undergo percutaneous coronary intervention (PCI). Premedication protocols and low-osmolality contrast media have been thought to improve the outcomes of these individuals. Objective: The objective of this study was to assess the prevalence and severity of allergic reactions during PCI in patients admitted for investigation of chest pain. Methods: This is a retrospective analysis of 13,652 patients who were hospitalized with chest pain during the years 2010-2016, at the Department of Internal Medicine, Meir Medical Center. Patient records were screened for diagnosis of prior ICM allergy. Primary outcomes were: (1) records of previous allergy to ICM, (2) administration of antiallergic premedication, and (3) allergic reactions to the ICM during the procedure. Results: Nine hundred thirty-one individuals without prior ICM allergy were referred for PCI, of whom 2 had minor allergic reactions. Previously diagnosed ICM allergy was recorded for 216 subjects (mean age 65.5 ± 10 years, 42% males). Of these, 32 were referred to in-hospital PCI. Premedication was administered in 10 cases only with no documented rationale for not treating the other 22. Only one of the pretreated patients experienced a reaction attributed to allergy, showing no statistical advantage for premedication. No mortality was documented in the 30 days after PCI among the patients with known ICM allergy. Conclusions: PCI did not induce substantial allergic reactions to ICM in patients with a previously diagnosed allergy. This study did not demonstrate an advantage for premedication.

Original languageEnglish
Pages (from-to)2059-2064
Number of pages6
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume6
Issue number6
DOIs
StatePublished - 1 Nov 2018

Keywords

  • Allergic reaction
  • Chest pain
  • Iodine allergy
  • Mortality
  • Percutaneous coronary intervention

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