LOW OR HIGH IODINE CONTENT OF CONTRAST-MEDIUM FOR CARDIAC ANGIOGRAPHY

Objective: To compare the diagnostic yield and the costs of a contrast agent with a lower iodine concentration, ioversol 300, versus the rou tinely used ioversol 350. Design and patients:In a prospective, random ized, double-blind study, ioversol 300 (group A patients) containing 3 00 mg/mL, of iodine was compared with the commonly used ioversol 350 ( group B patients) containing 350 mg/mL of iodine using a visual scorin g system (1 = worst, 5 = best) with respect to image quality, fluorosc opy time, and amount of contrast and iodine used for coronary angiogra phy and left ventriculography in 300 consecutive patients. The study w as performed in two catheterization laboratories of different technica l standards (high resolution with digital image treatment stored on Su per VHS tapes in patients 1-170 and conventional 35-mm cine films in p atients 171-300). Results: In group A, the quality scores for coronary angiography and left ventriculography were 4.4 (+/- 0.7) and 4.0 +/- 0.8) in patients 1-170 and 3.7 (+/- 0.8) and 4.0 (+/- 0.8) in patients 177-300, whereas in group B the values were 4.4 (+/- 0.6) and 4.5 (+/ -0.6) for patients 1-170 and 3.7 (+/- 0.8) and 4.0 (+/- 0.8) for patie nts 171-300 (all NS). Fluoroscopy time (min) in group A was 9.4 (+/- 6 .1) in patients 1-170 and 11.1 (+/- 8.8) in patients 171-300 and 11.0 (+/- 6.6) and 10.1 (+/- 5.7) in group B, respectively (NS). Contrast v olume (mL) and iodine amount (g) in group A were 201.1 (+/- 55.4) and 60.3 (+/- 16.6) for patients 1-170 and 198.2 (+/- 46.4) and 59.3 (+/- 13.9) for patients 171-300 (NS). In group B, the corresponding numbers were 202.4 (+/- 61.7) and 70.8 (+/- 21.6) in patients 1-170 and 200.0 (+/- 49.4) and 70.0 (+/- 17.3) in patients 171-300 (P = 0.0042, patie nts 1-170 and P = 0.0002, patients 171-300 for iodine amount). The ave rage cost of the contrast agent (Swiss francs) was 185.85 +/- 47.9 in group A and 204.40 +/- 52.4 in group B (P < 0.001). Conclusion: The us e of ioversol 300 reduced the total iodine burden for cardiac catheter ization with unaltered image quality and fluoroscopy time, while the c osts were reduced by 9.1%.