Cardiac ultrasound contrast completely safe, despite reports to the contrary
A large new analysis offers evidence contradicting the results of a prior report that suggested ultrasound enhancing agents (UEA) used for transthoracic or stress echocardiography (TTE/SE) pose increased safety risks to patients.
Use of UEAs is known to significantly improve echocardiography assessments, as they offer enhanced visualization of the endocardial border. Although there are known risks associated with contrast, the findings show there has been a recent uptick in adverse reactions to contrast agents used in TTE/SE exams.
However, prior studies have yielded conflicting results with respect to the risk of reactions.
“Pharmacovigilance reporting several years ago suggested that one possible explanation for these rare allergic reactions may be related to the polyethylene glycol component found in certain UEAs but did not find that the rate of reactions had increased,” Jordan B. Strom, MD, with the Cardiovascular Division of Beth Israel Deaconess Medical Center in Boston, and colleagues explained. “However, a recent report described an increase in severe allergic reactions to UEAs, further suggesting that the risk of severe and critical adverse drug reactions may differ by agent and may be related to history of prior receipt of COVID‐19 vaccination.”
To get a better idea of the actual rate of adverse events related to UEAs, the team incorporated data from millions of patients, more than 500,000 of whom were given a UEA for their stress test. Of the entire sample, during the two days after their exam there were fewer adverse events recorded in the group who received contrast compared to the one who did not, at 0.02% versus 0.14%. What’s more, these numbers were similar across three contrast agents routinely used in cardiac care—Definity, Lumason and Optison—and did not diverge during any of the years studied, both prior to and after COVID.
“Overall, these findings suggest the continued safety profile of UEAs in contemporary practice,” the authors wrote. “Moreover, they suggest that safety differences between agents should be contextualized by the setting of administration, the comorbidities of those receiving UEAs, and the route/manner of administration.”
Learn more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.