EFFECTS OF BETA-ADRENERGIC AND CALCIUM-ANTAGONISTS ON THE DEVELOPMENT OF ANAPHYLACTOID REACTIONS FROM RADIOGRAPHIC CONTRAST-MEDIA DURING CARDIAC ANGIOGRAPHY

[摘要] Anaphylactoid reactions (ARs) occurring in patients receiving propranolol have been described as unusually severe and having a sluggish response to epinephrine. Although the mechanism of ARs to iodinated radiographic contrast media is not IgE mediated, because of widespread use of .beta.-adrenergic blocking agents, we undertook a prospective study to determine the incidence of AR to radiographic contrast media during cardiac angiography. Nine hundred fifty-two consecutive patients were divided into four groups according to concomitant chronic medications. Group I (447 patients) were receiving no .beta.-adrenergic blocking agents or calcium antagonists. Group II (216 patients) were receiving a .beta.-adrenergic blocking agent. Group III (147 patients) were receiving a calcium antagonist but not a .beta.-adrenergic blocking agent. Group IV (142 patients) were receiving both a calcium antagonist and a .beta.-adrenergic blocking agent. The reaction rates, respectively, in the four groups were 4.47%, 7.41%, 5.44%, and 4.93%. The rates of ARs were not associated with the use of concomitant medications in any of the groups (.chi.2 = 2.531; p = 0.47). The probability of a type II error in comparison of groups I and II was 0.75 should the true incidence of reactions in patients receiving .beta.-adrenergic antagonists be 7.41%. No difference in the incidence of AR was observed between patients taking selective and nonselective .beta.-adrenergic blocking agents in group II. Specific ARs occurring in patients receiving .beta.-adrenergic blocking agents were usually mild and often without need for specific pharmacotherapy.

[发布日期] 1987-11-01