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Patients with iodinated contrast dye allergy usually receive premedication before diagnostic angiography and percutaneous intervention. Whether the contrast dye allergy or the premedication affects these patients’ risk for contrast-induced nephropathy or their long-term outcomes is not known. We studied the association between dye allergy and long-term outcomes in patients undergoing diagnostic angiography and percutaneous intervention.
Methods and Results
We studied 2713 predominantly (98%) male patients undergoing peripheral and coronary angiography/cardiac catheterization and percutaneous coronary and endovascular intervention. The mean age was 68 years. A total of 128 (4.7%) patients had contrast dye allergy. The dye allergy patients had similar baseline creatinine, and did not differ in medical therapy from the patients without dye allergy. Information on creatinine at 3 months was available on 1327 patients. Renal dysfunction occurred in 6 (8.82%) patients with dye allergy and 170 (13.5%) in patients without allergy at 3 months after the procedure (odds ratio [OR] 0.62; 95% confidence interval [CI] 0.26-1.46; P=0.24). After a follow-up of 60 months, 1 patient (0.78%) of the dye allergy group was placed on dialysis versus 42 (1.62 %) patients of the group without dye allergy (OR 0.48, CI 0.07-3.49; P=0.46) and 21 patients (16.41%) died of any cause among the group with dye allergy versus 600 (23.21%) patients of the no allergy group (OR 0.65, CI 0.40-1.05; P=0.06). On multivariate analysis, after adjustment for age, comorbidities and baseline creatinine, dye allergy was not significantly associated with renal dysfunction at 3 months (OR 1.02, CI 0.52-1.99; P=0.94), and with starting of dialysis (OR 0.63, CI 0.28-47.69; P=0.63) but was significantly and inversely associated with death (OR 0.50, CI 0.24-0.82; P=0.007).
In this cohort of patients, iodinated contrast dye allergy was not associated with the development of renal dysfunction at 3 months after diagnostic angiography or percutaneous intervention or of long-term development of end-stage renal disease requiring dialysis. The association between dye allergy and reduced mortality needs to be confirmed in a larger cohort.
- 2013 American College of Cardiology Foundation