Prospective evaluation of risk factors for acute adverse reactions to iodinated contrast media in contrast-enhanced CT.
4 affiliations
- 1Department of Radiology, Fuwai Central China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- 2Department of Cardiac Surgery, Fuwai Central China Cardiovascular Hospital, Henan Provincial Clinical Research Center for Cardiovascular Disease, Zhengzhou, Henan, China.
- 3Center of Structural Heart Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China.
- 4Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States.
Abstract
Objective
This study aimed to identify clinical risk factors for acute adverse reactions (AARs) to iodinated contrast media (ICM) during contrast-enhanced CT.Methods
In this prospective study, A total of 1,462 patients with contrast-enhanced CT scans were continuously enrolled between October and December 2020 in a Class A tertiary cardiovascular specialty hospital. Blood samples were collected before the scan to determine serum immunoglobulin E (IgE), eosinophil (EOS) counts, and glucose levels. Demographic data and clinical characteristics were extracted from the hospital information system and pre-designed case report forms. Multivariate Firth logistic regression and receiver operating characteristic (ROC) analyses for these factors were performed to assess predictors of AARs.Results
Among 1,462 patients, 62 (4.24%) experienced AARs, including 20 (1.37%) acute allergic-like reactions. Cardiac insufficiency (OR = 1.983, 95% CI: 1.115-3.525), age (OR = 0.980, 95% CI: 0.961-0.999), ICM type (OR = 2.221, 95% CI: 1.320-3.737), CT examination type (OR = 0.492, 95% CI: 0.289-0.837), prior ICM reaction history (OR = 35.411, 95% CI: 6.408-195.700), and allergy history (OR = 3.327, 95% CI: 1.655-6.688) were independent risk factors for AARs. Hyperlipidemia might be potentially associated with AARs. Elevated baseline IgE, ICM type, and gout might be potentially associated with acute allergic-like reactions. EOS and blood glucose levels showed no significant association.Conclusion
Cardiac insufficiency, age, ICM type, CT examination type, prior ICM reactions, and allergy history are key risk factors for AARs. The following exploratory associations require multi-center validation: hyperlipidemia may have a potential association with AARs; baseline IgE levels, ICM type and gout may be associated with acute allergic-like reactions.
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BibTeX
@article{xie2026prospective,
title = {{Prospective evaluation of risk factors for acute adverse reactions to iodinated contrast media in contrast-enhanced CT.}},
author = {Ruigang Xie and Hui Zhang and Junjie Sun and Haibo Hu and U Joseph Schoepf and Yinghui Ge},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1870320},
url = {https://europepmc.org/article/MED/42921188},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prospective evaluation of risk factors for acute adverse reactions to iodinated contrast media in contrast-enhanced CT.
AU - Ruigang Xie
AU - Hui Zhang
AU - Junjie Sun
AU - Haibo Hu
AU - U Joseph Schoepf
AU - Yinghui Ge
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1870320
UR - https://europepmc.org/article/MED/42921188
AB - Objective This study aimed to identify clinical risk factors for acute adverse reactions (AARs) to iodinated contrast media (ICM) during contrast-enhanced CT.Methods In this prospective study, A total of 1,462 patients with contrast-enhanced CT scans were continuously enrolled between October and December 2020 in a Class A tertiary cardiovascular specialty hospital. Blood samples were collected before the scan to determine serum immunoglobulin E (IgE), eosinophil (EOS) counts, and glucose levels. Demographic data and clinical characteristics were extracted from the hospital information system and pre-designed case report forms. Multivariate Firth logistic regression and receiver operating characteristic (ROC) analyses for these factors were performed to assess predictors of AARs.Results Among 1,462 patients, 62 (4.24%) experienced AARs, including 20 (1.37%) acute allergic-like reactions. Cardiac insufficiency (OR = 1.983, 95% CI: 1.115-3.525), age (OR = 0.980, 95% CI: 0.961-0.999), ICM type (OR = 2.221, 95% CI: 1.320-3.737), CT examination type (OR = 0.492, 95% CI: 0.289-0.837), prior ICM reaction history (OR = 35.411, 95% CI: 6.408-195.700), and allergy history (OR = 3.327, 95% CI: 1.655-6.688) were independent risk factors for AARs. Hyperlipidemia might be potentially associated with AARs. Elevated baseline IgE, ICM type, and gout might be potentially associated with acute allergic-like reactions. EOS and blood glucose levels showed no significant association.Conclusion Cardiac insufficiency, age, ICM type, CT examination type, prior ICM reactions, and allergy history are key risk factors for AARs. The following exploratory associations require multi-center validation: hyperlipidemia may have a potential association with AARs; baseline IgE levels, ICM type and gout may be associated with acute allergic-like reactions.
SN - 2296-858X
ER -