Anshul Aggarwal1, James L Smith1, Kavitha M Chinnaiyan2, Neesurg Mehta1, Judith Boura3, Rami Khoury Abdulla1, Carl B Lauter4, Gilbert L Raff5. 1. Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA. 2. Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA; Oakland University William Beaumont School of Medicine, Rochester, MI, USA. 3. Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Beaumont Health Research Institute, Royal Oak, MI, USA. 4. Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Section of Allergy and Immunology, Department of Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA. 5. Department of Cardiovascular Medicine, Beaumont Health System, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA; Oakland University William Beaumont School of Medicine, Rochester, MI, USA. Electronic address: GRaff@beaumont.edu.
Abstract
BACKGROUND: β-Blockers are often used for heart rate control during coronary CT angiography (CTA). Increased frequency and severity of allergic reactions to radiocontrast media (RCM) have been reported with concomitant use of β-blockers. OBJECTIVES: The objectives of this study were to determine whether there is a higher incidence of allergic reactions to low-osmolar nonionic RCM in patients undergoing coronary CTA with concomitant β-blockers and to define the overall incidence and severity of allergic reactions in patients undergoing coronary CTA with and without a history of allergy to RCM. METHODS: Patients undergoing coronary CTA at 47 institutions participating in the Advanced Cardiovascular Imaging Consortium registry were analyzed. The incidence and severity of allergic reactions were compared between those patients who did and those who did not receive β-blockers, as well as in subgroups of patients with and without a history of prior allergy to RCM. RESULTS: The incidence of allergic reaction in patients who received β-blockers was 45 of 23,867 (0.19%) compared with those who did not receive β-blockers, which was 9 of 5232 (0.17%; P = .84; odds ratio = 1.1). Of the patients with history of allergy to RCM, 4 of 706 patients (0.6%) on β-blockers experienced allergic reactions compared to 1 of 77 patients (1.3%) without β-blockers (P = .40; odds ratio = 0.43). CONCLUSIONS: β-Blocker pretreatment had no effect on the frequency or severity of allergic reaction in patients undergoing coronary CTA, even in patients with a past history of allergy to RCM.
BACKGROUND: β-Blockers are often used for heart rate control during coronary CT angiography (CTA). Increased frequency and severity of allergic reactions to radiocontrast media (RCM) have been reported with concomitant use of β-blockers. OBJECTIVES: The objectives of this study were to determine whether there is a higher incidence of allergic reactions to low-osmolar nonionic RCM in patients undergoing coronary CTA with concomitant β-blockers and to define the overall incidence and severity of allergic reactions in patients undergoing coronary CTA with and without a history of allergy to RCM. METHODS:Patients undergoing coronary CTA at 47 institutions participating in the Advanced Cardiovascular Imaging Consortium registry were analyzed. The incidence and severity of allergic reactions were compared between those patients who did and those who did not receive β-blockers, as well as in subgroups of patients with and without a history of prior allergy to RCM. RESULTS: The incidence of allergic reaction in patients who received β-blockers was 45 of 23,867 (0.19%) compared with those who did not receive β-blockers, which was 9 of 5232 (0.17%; P = .84; odds ratio = 1.1). Of the patients with history of allergy to RCM, 4 of 706 patients (0.6%) on β-blockers experienced allergic reactions compared to 1 of 77 patients (1.3%) without β-blockers (P = .40; odds ratio = 0.43). CONCLUSIONS: β-Blocker pretreatment had no effect on the frequency or severity of allergic reaction in patients undergoing coronary CTA, even in patients with a past history of allergy to RCM.