The Effect of Iodinated Contrast Media Sensitivity on the Prognosis of Patients with STEMI
Abstract
:1. Introduction
Grade | Allergic-like | Physiologic |
Mild: self-limiting without evidence of progression | limited urticaria, cutaneous edema, limited “scratchy” throat, nasal congestion, conjunctivitis | Limited nausea, transient flushing, headache, mild hypertension, spontaneous vasovagal reaction |
Moderate: pronounced symptoms that usually require medical attention | Diffuse urticaria, diffuse erythema, stable vital signs, throat tightness w/o dyspnea, bronchospasm, mild to no hypoxia | Protracted nausea, hypertensive urgency, isolated chest pain, vasovagal reaction requiring and responding to treatment |
Severe: Often life-threatening and can result in death or permanent morbidity | Diffuse edema with dyspnea, Diffuse erythema with hypotension, laryngeal edema with stridor and/or hypoxia, bronchospasm, anaphylactic shock | Vasovagal reaction resistant to treatment, arrhythmia, convulsions, seizures, hypertensive emergency |
2. Materials and Methods
2.1. Data Source
2.2. Study Design and Population
2.3. Outcomes
2.4. Statistical Analysis
2.5. Ethical Issues
3. Results
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Non-ICM-Sensitive | ICM-Sensitive | p-Value | |
---|---|---|---|
Number of weighted records | 659,715 (99.3%) | 4905 (0.7%) | |
Age (Mean, Median, IQR) | 64 (63, 18) | 67 (67, 17) | |
Gender | <0.001 | ||
Male | 69.6% | 53.1% | |
Female | 30.4% | 46.9% | |
Race (uniform) | <0.001 | ||
White | 75.3% | 80.4% | |
Black | 8.9% | 10.2% | |
Hispanic | 8.7% | 5.4% | |
Asian or Pacific Islander | 3.0% | 1.6% | |
Native American | 0.5% | 0.5% | |
Other | 3.6% | 1.8% | |
Region of hospital | 0.03 | ||
Northeast | 17.2% | 18.6% | |
Midwest | 22.8% | 22.8% | |
South | 39.8% | 40.3% | |
West | 20.2% | 18.3% | |
Location/teaching status of hospital (STRATA) | 0.153 | ||
Rural | 6.1% | 6.0% | |
Urban nonteaching | 22.6% | 21.5% | |
Urban teaching | 71.3% | 72.5% | |
Median household income national quartile for patient ZIP Code | <0.001 | ||
1st | 28.1% | 32.0% | |
2nd | 27.2% | 27.4% | |
3rd | 24.6% | 23.1% | |
4th | 20.1% | 17.5% | |
Primary expected payer (uniform) | <0.001 | ||
Medicare | 44.9% | 59.7% | |
Medicaid | 10.6% | 9.4% | |
Private insurance | 33.9% | 23.6% | |
Self-pay | 6.8% | 3.4% | |
No charge | 0.6% | 0.3% | |
Other | 3.2% | 3.7% | |
Record Characteristics | |||
Cardiac Arrest | 6.2% | 4.2% | <0.001 |
Ventricular Fibrillation | 8.4% | 4.8% | <0.001 |
Ventricular Tachycardia | 12.3% | 11.0% | 0.006 |
Cardiogenic Shock | 13.7% | 10.2% | <0.001 |
Length of stay, (days), median (IQR) | 4 (2, 2) | 3.87 (3, 2) | |
Total charge, (USD), median (IQR) | 116,369 (82,872, 76,212) | 111,378 (83,429, 76,776) | |
Comorbidities | |||
Previous MI | 11.8% | 17.8% | <0.001 |
Cerebrovascular disease | 2.6% | 4.3% | <0.001 |
Heart failure | 24.7% | 26.6% | <0.001 |
Valvular disease | 8.4% | 10.8% | <0.001 |
Atrial fibrillation/flutter | 14.6% | 17.3% | <0.001 |
Hypertension | 72.6% | 82.3% | <0.001 |
Dyslipidemia | 64.0% | 71.2% | <0.001 |
Diabetes Mellitus | 32.1% | 36.3% | <0.001 |
Smoker | 51.9% | 55.9% | <0.001 |
Peripheral vascular disease | 6.1% | 10.5% | <0.001 |
Chronic lung disease | 12.2% | 16.5% | <0.001 |
Chronic renal failure | 12.9% | 20.3% | <0.001 |
Obesity | 17.2% | 18.8% | 0.004 |
Anemia | 14.8% | 17.4% | <0.001 |
Thrombocytopenia | 4.1% | 4.0% | 0.705 |
Coagulopathy | 1.9% | 2.3% | 0.012 |
Dementia | 3.3% | 4.0% | 0.011 |
Chronic Liver Disease | 0.3% | 0.4% | 0.408 |
Solid malignancy | 1.8% | 2.4% | 0.001 |
Hematologic Malignancies | 0.7% | 1.1% | <0.001 |
Metastatic cancer | 0.7% | 1.7% | <0.001 |
Non-ICM-Sensitive | ICM-Sensitive | p-Value | |
---|---|---|---|
Number of weighted records | 659,715 (99.3%) | 4905 (0.7%) | |
In-hospital procedures | |||
Coronary Angiography | 91.5% | 90.6% | 0.022 |
PCI | 79.6% | 76.9% | <0.001 |
CABG | 5.2% | 4.2% | 0.002 |
Thrombolysis | 0.6% | 0.3% | 0.015 |
Circulatory support (inc. IABP, LV assist device and ECMO) | 10.5% | 9.1% | 0.001 |
Mechanical Ventilation | 11.2% | 7.8% | <0.001 |
In-hospital Outcomes | |||
MACCE | 12.0% | 12.0% | 0.951 |
Mortality | 7.9% | 7.2% | 0.086 |
Acute Ischemic CVA | 1.4% | 1.3% | 0.742 |
Major Bleeding | 3.3% | 2.4% | 0.001 |
○ GI bleed | 1.9% | 1.4% | 0.025 |
○ Procedural related bleeding | 1.1% | 0.7% | 0.018 |
○ Retroperitoneal Bleed | 0.2% | 0.3% | 0.065 |
○ Intracranial Hemorrhage | 0.3% | 0.2% | 0.199 |
OR (95% CI) | OR p-Value | |
---|---|---|
Mortality | 1.02 (0.89–1.16) | 0.798 |
MACCE | 1.05 (0.95–1.16) | 0.355 |
Major bleeding | 0.73 (0.60–0.87) | 0.001 |
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Roguin, A.L.; Birati, E.Y.; Kobo, O.M. The Effect of Iodinated Contrast Media Sensitivity on the Prognosis of Patients with STEMI. Medicina 2024, 60, 973. https://doi.org/10.3390/medicina60060973
Roguin AL, Birati EY, Kobo OM. The Effect of Iodinated Contrast Media Sensitivity on the Prognosis of Patients with STEMI. Medicina. 2024; 60(6):973. https://doi.org/10.3390/medicina60060973
Chicago/Turabian StyleRoguin, Alon L., Edo Y. Birati, and Ofer M. Kobo. 2024. "The Effect of Iodinated Contrast Media Sensitivity on the Prognosis of Patients with STEMI" Medicina 60, no. 6: 973. https://doi.org/10.3390/medicina60060973