Development of a surveillance system for monitoring contrast media-related adverse events in patients undergoing coronary angiography
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Abstract
BACKGROUND: Contrast media have been developed for use in coronary angiography, which is a procedure for diagnosing coronary artery disease. However, some patients may experience adverse reactions, such as contrast media allergy and contrast media associated with acute kidney injury. Therefore, the development of a safety monitoring system is essential for surveillance, analysis, follow-up, and implementation of risk strategies to enhance patient safety.
OBJECTIVE: To develop a surveillance system for monitoring contrast media-related adverse events in patients undergoing coronary angiography, and to evaluate its effects on patients and healthcare professionals’ opinions.
METHODS: This study was an action research project based on the conceptual framework of Kemmis and McTaggart. It aims to develop a surveillance system for adverse reactions to contrast media in patients undergoing coronary angiography at Chiangrai Prachanukroh Hospital. The implemented development system was evaluated both in terms of patient safety and the opinions of research participants. This study was conducted between 1 December 2024 to 30 June 2025.
RESULTS: In the developed system, pharmacists assumed an additional role in conducting risk assessments and monitoring patients for adverse reactions to contrast media following coronary angiography. After the system’s development, a total of 62 patients were enrolled, and 2 cases experienced contrast media adverse reactions (3.23%), of which 1.61% had delayed adverse reactions with moderate severity. Contrast media associated with acute kidney injury were found in 1.61 percent of patients. The mean opinion score after development was significantly higher than that before development (mean difference = – 0.35; 95% CI: – 0.92 to – 0.17; p=0.002).
CONCLUSIONS AND RECOMMENDATIONS: Systematic surveillance for contrast media-related adverse events in patients undergoing coronary angiography can reduce potential risks and provide a more comprehensive understanding of the incidence of adverse reactions. Therefore, the system should be applied and expanded to include patients receiving contrast media for other procedures and those receiving other high-risk medications.
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References
Khananuraksa P, Kuntiranont K, Tresukosol D, Piamsomboo C, Kositchaiwat J, Pornvipavee R, et al. Long-term mortality and morbidity at one year among Universal Coverage (UC) Thai patients undergone cor-onary angiography without further cardiac interventions (CAG only) from 2020 – 2022. Journal of Health Science of Thailand 2024;33(3):505-16.
American College of Radiology. ACR manual on Ccntrast media. [Internet].2023 [cited 2024 June 21]. Available from: https://www.acr.org/-media/ACR/Files/Clinical-Resources/Contrast_Media.pdf
Rerkvaleekul S, Phattanarudee S, Muangsomboon K, Janpanich S. Risk factors for acute allergic-like reaction to nonionic contrast media. Thai Journal of Pharmacy Practice. 2021;13(3):658-74.
Cha MJ, Kang DY, Lee W, Yoon SH, Choi YH, Byun JS, et al. Hypersensitivity reactions to lodinated contrast media: a multicenter study of 196 081 patients. Radiology. 2019;293(1):117-24.
Sutheewasinnon P, Pasunon P. Sampling strategies for qualitative research. Parichart Journal. 2559;29(2):31-48.
Chaopathomkun B, editor. Manual of recommendations for the rational use of medicines according to the National List of Essential Medicines: contrast media. Bangkok: Aksorn graphic and design; 2017.
European Society of Urogenital Radiology. ESUR Guidelines on Contrast Agent version 10.0 [Internet]. [update 2018; cited 2024 June 21]. Available from: https://www.esur.org/wp-content/uploads/2022/03/ESUR-Guidelines-10_0-Final-Version.pdf
Rerkvaleekul S. Factors associated with acute allergic-like reaction to nonionic iodinated contrast media [dissertation]. Bangkok: Chulalongkorn University; 2019.
Jiang H, Li Y, Wu X, Yu H, Zhang X, Ge W, et al. Pharmacist-led iodinated contrast media infusion risk assessment service. Front Pharmacol [Internet]. 2023 May 9 [cited 2024 Jun 21]. Available from: https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1161621/full
Ritklar L, Piyayotai D. Effects of clinical nursing practice guideline for nursing care of patients with coronary artery disease: undergone coronary angiography on complications and anxiety levels in medical unit, Thammasat University Hospital. Nursing Journal. 2019;46(4):149-57.
Chaopathomkul B. Guideline for rational drug use according to the national essential drug list diagnostic aids in diagnostic radiology [Internet]. Bangkok: The Royal College of Radiologists of Thailand; 2018 [updated April; cited 2025 July 25]. Available from: https://www.rcrt.or.th/contrast-media/
Witoon R, Patpituk T. Incidences of contrast-induced nephropathy, and associated factors in patients with chronic kidney disease at Burapha University Hospital. BJM. 2021;8(2):55-71.
Silairatana S. Contrast-associated acute kidney injury[Internet]. Bangkok: Wongkanpat Plus Media; n.d. [cited 2025 June 20]. Available from: https://www.wongkarnpat.com/viewpat.php?id=2781
