Iodixanol, a new isosmotic nonionic contrast agent compared with iohexol in cardiac angiography

Area of Science:

• Radiology and Imaging
• Cardiovascular Medicine
• Pharmacology

Background:

• Nonionic iodinated contrast agents are essential for diagnostic cardiac angiography.
• Iodixanol, a new isoosmolar agent, offers potential advantages in patient comfort and safety.
• Comparing iodixanol with established agents like iohexol is crucial for clinical practice.

Purpose of the Study:

• To compare the safety and efficacy of iodixanol versus iohexol in patients undergoing elective diagnostic cardiac angiography.
• To assess hemodynamic and electrophysiologic parameters, patient-reported discomfort, and angiographic quality.

Main Methods:

• A randomized, double-blind, parallel study involving 200 patients undergoing cardiac angiography.
• Patients were randomized to receive either iodixanol (n=101) or iohexol (n=99).
• Key outcomes included changes in blood pressure, heart rate, electrophysiologic parameters, patient discomfort, and angiographic quality.

Main Results:

• No significant differences in hemodynamic parameters or overall angiographic quality were observed between iodixanol and iohexol.
• Iodixanol was associated with significantly less moderate to severe injection-associated discomfort compared to iohexol (17% vs 52%).
• Minor differences in PR prolongation (iodixanol) and ST-segment depression (iohexol) were not clinically significant. One serious adverse event (ventricular fibrillation) occurred with iohexol.

Conclusions:

• Iodixanol is a safe and effective contrast agent for cardiac angiography, comparable to iohexol in this low-risk population.
• Iodixanol offers a significant improvement in patient comfort during the procedure.
• Further studies in high-risk patients are warranted to fully define iodixanol's role in cardiac angiography.