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Acute AEs With Gadolinium-Based Contrast Agents Low in Cardiac MRI

WEDNESDAY, Nov. 4, 2020 -- Gadolinium-based contrast agents (GBCAs) appear to be safe for most patients undergoing cardiac magnetic resonance imaging (MRI), according to a study published online Oct. 29 in Radiology: Cardiothoracic Imaging.

Given recent suspensions of GBCA approval, Johannes Uhlig, M.D., M.P.H., from the University Medical Center Goettingen in Germany, and colleagues examined current use and safety profiles of GBCAs in cardiac MRI in a retrospective study involving patients from the multinational European Society of Cardiovascular Radiology MR/CT Registry. GBCA-associated acute adverse events (AAEs) were classified as mild, moderate, and severe.

The researchers found that 94.2 percent of the 154,779 patients who underwent cardiac MRI underwent administration of GBCAs. Linear GBCAs were used in 15.2 percent of examinations through 2011, but their use declined to less than 1 percent in 2018 and 2019. Overall, AAEs were documented in 0.36 percent (556 examinations): 0.12, 0.21, and 0.03 percent were mild, moderate, and severe, respectively. Examination-related events were reported in 2.59 percent of cases for nonenhanced cardiac MRI, most of which were anxiety and dyspnea (0.98 and 0.93 percent, respectively). There was significant variation noted in AAE rates by pharmacologic stressor, GBCA molecular structure (macrocyclic versus linear: multivariable odds ratio, 0.634), GBCA subtype, and imaging indication.

"The administration of GBCA for cardiac MRI is safe for the overwhelming majority of patients," Uhlig said in a statement. "In particular, macrocyclic GBCAs exhibit a favorable acute safety profile."

Two authors disclosed financial ties to the medical device and medical technology industries.

Abstract/Full Text

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Posted: November 2020

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