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Coagulation disorders of the intrinsic and extrinsic pathways are monitored by measuring such clotting times as partial thromboplastin time (PTT), prothrombin time (PT), and thrombin time (TT). These laboratory tests reflect the congenital and acquired deficiencies of clotting factors and are used for controlling anticoagulant therapy. We have previously reported that meglumine (cation) in radiologic contrast media (CM) inhibits factor VIII, IX, and thrombin (Fed. Proc. 36 (3), 317, 1977) and consequently prolonges clotting times. The effects of ionic and nonionic CM on pathological plasma were investigated by employing routine clotting assays. Patient plasmas showing PT values &gt;15 secs., were mixed with Renografin-60 (Squibb and Sons, Princeton, New Jersey), P-297, iothalamic acid, and ioxigalic acid (Laboratoire Guerbet, Paris, France) and PTs were then determined. Renografin-60 (30 mg/ml), iothalamic acid (10 mg/ml) and ioxigalic acid (10 mg/ml) produced an increase in the PT values by 60-80% base levels, whereas no such effect was seen with P-297. In normal plasma (NHP), the PT values were elevated only by 5-10%. In another study, patient plasmas showing PTT &gt; 40 secs., were supplemented with CM and the mixtures were assayed for PTT. Except with P-297 there was a 50-60% increase in PTT due to the interactions of ionic CM. Our studies show that during anticoagulant therapy, if clotting assays are performed immediately after radiologic diagnostic procedures, utilizing intravascular contrast agents, erroneous conclusions can be drawn. Our studies have also shown that certain ionic CM can produce transient effects on coagulation parameters and therefore, due consideration be given to the presence of these agents in patients suffering from platelet function defects and other coagulation disorders.

Effect Of Radiologic Contrast Agents On Laboratory Parameters Used In The Evaluation Of Hemostatic Function