Double-blind study of a new nonionic contrast agent for cardiac angiography

A randomized, double-blind study of a new nonionic contrast agent (ioversol) was performed in 80 patients undergoing routine coronary angiography and left ventriculography. Its hemodynamic and electrocardiographic (ECG) effects were compared with those of a conventional ionic contrast agent (sodium meglumine diatrizoate). There were 40 patients in each group. The radiographic quality and incidence of adverse reactions were comparable for both agents. Following left ventriculography, there was a smaller decrease in systemic and left ventricular systolic blood pressure and a smaller increase in heart rate and pulmonary artery systolic pressure (P less than .05) with ioversol than with meglumine diatrizoate. There was also a slight decrease in cardiac output with ioversol at 1 and 3 minutes after left ventriculography, while meglumine diatrizoate produced a modest increase. In selective coronary angiography, the fall in diastolic blood pressure was also greater (P less than .05). The Q-T interval was more prolonged with meglumine diatrizoate. Ioversol appears to be both safe and efficacious for cardiac angiography, causing fewer and less severe hemodynamic and ECG alterations than meglumine diatrizoate.