Increased plasma levels of PAI-1 after administration of nonionic contrast medium in patients undergoing pulmonary angiography.

Abstract

To compare the effects of ionic and nonionic contrast media on markers of the coagulation, fibrinolytic, and contact systems. Low-osmolar ionic (ioxaglate) or nonionic (iohexol) contrast material was administered to 14 patients undergoing pulmonary angiography for suspected pulmonary embolism. Blood samples were obtained before and after the procedure and were analyzed for fibrinolysis and coagulation indicators such as plasminogen activator type 1 (PAI-1) activity, thrombin-antithrombin III (TAT) complexes, and platelet activation. Both contrast agents caused a significant increase in TAT complexes. PAI-1 levels increased significantly in patients who received iohexol but not in those who received ioxaglate. Platelet activation was more pronounced in patients who received iohexol. The increase in PAI-1 levels in response to iohexol may explain clinical differences in postprocedural thrombogenicity in patients who undergo angiography.