IODIXANOL, A NEW ISOSMOTIC NONIONIC CONTRAST AGENT COMPARED WITH IOHEXOL IN CARDIAC ANGIOGRAPHY

Iodixanol, a new ratio 6 nonionic iodinated contrast agent with an osm olality equal to a serum, was compared with iohexol in a randomized, d ouble-blind, parallel study. Two hundred patients undergoing elective diagnostic cardiac angiography were randomized to iodixanol (n = 101) or iohexol (n = 99). There were no differences noted between the 2 age nts in the mean changes in systolic or diastolic blood pressure or hea rt rate during or immediately after any angiography. However, signific antly more patients had a decrease in diastolic blood pressure of >20 mm Hg during left coronary angiography with iodixanol. The only signif icant differences in any electrophysiologic parameter were slightly mo re PR prolongation during left coronary angiography with iodixanol and more ST-segment depression with iohexol during coronary angiography. Neither was clinically significant. Injection-associated discomfort oc curred with both agents, but more patients experienced moderate to sev ere discomfort with iohexol (52%) than with iodixanol (17%) (p <0.001) . Only 1 potentially serious adverse event, ventricular fibrillation w ith iohexol, was considered related to contrast, and there were no dif ferences noted between agents. Overall, angiographic quality was equal with all angiograms being assessed as good or excellent in both group s (p = 0.885). In this low-risk population undergoing cardiac angiogra phy, iodixanol is safe and effective without clinically important diff erences from iohexol. Additional studies in patients at high risk for complications should help further define the role of iodixanol in card iac angiography.