A nephroprotective iodinated contrast agent with cardioprotective properties: A pilot study

Rowe, Elizabeth S.; Rowe, Vernon D.; Hunter, John; Gralinski, Michael R.; Neves, Liomar A.

BACKGROUND AND PURPOSE: Evaluation and treatment of acute ischemic syndromes, in the heart and brain, require vessel visualization by iodinated X‐ray contrast agents. However, these contrast agents can induce injury, in both the kidneys and target organs themselves. Sulfobutylether beta cyclodextrin (SBECD) added to iohexol (SBECD‐iohexol) (Captisol Enabled‐iohexol, Ligand Pharmaceuticals, Inc, San Diego, CA) is currently in clinical trials in cardiovascular procedures, to determine its relative renal safety in high‐risk patients. Preclinical studies showed that SBECD‐iohexol reduced contrast‐induced acute kidney injury in rodent models by blocking apoptosis. The current study was undertaken to determine whether SBECD‐iohexol is also cardioprotective, in the male rat ischemia‐reperfusion model, compared to iohexol alone. METHODS: After anesthesia, the left coronary artery was ligated for 30 min and the ligation released and reperfusion followed for 2 h prior to sacrifice. Groups 1–4 were injected in the tail vein 10 min prior to ischemia with: (1) vehicle; (2) iohexol; (3) SBECD; and (4) SBECD‐iohexol. Infarct size, hemodynamics, and serum markers were measured. RESULTS: An eight‐fold increase in serum creatine kinase in the iohexol‐alone group was observed, compared with no increase in the SBECD‐iohexol group. The mean arterial pressure and rate pressure product were depressed in the iohexol‐alone group, but not in the SBECD‐iohexol group, or controls. No difference in infarct size or serum creatinine among the groups was observed. CONCLUSION: The results of this study suggest that SBECD‐iohexol is superior to iohexol alone, for both the preservation of cardiomyocyte integrity and preservation of myocardial function in myocardial ischemia.