Multicenter trial of ionic versus nonionic contrast media for cardiac angiography

Abstract Contrast agents used for cardiac anglography are different in regard to ionicity, osmolality and physiologic effects. The nonionic contrast media have been shown to have less toxic effects and a better safety profile than do higher osmolar agents. To better assess this risk, clinically stable patients undergoing cardiac anglography were stratified according to the presence of diabetes mellitus, and level of serum creatinine, and then randomized to receive either iohexol (Omnipaque 350 TM ) or sodium meglumine diatrizoate (Renogratin 76 TM ). All adverse events that occurred during and immediately after anglography were tabulated. A multivariate model was used to identify patients at increased risk for adverse outcome. The 1,390 patients were randomized to iohexol (n = 696) or diatrizoate (n = 694). Significant differences were found in the number of patients with contrast media-related adverse (iohexol vs diatrizoate:10.2 vs 31.6%; p