Immediate and LAte Adverse Reactions in Coronary Angiography

Abstract

Purpose and Methods: In 120 patients in a double-blind, randomized, parallel study, iodixanol (Visipaque), a nonionic dimer isotonic with blood, was compared with ioxaglate (Hexabrix), an ionic low-osmolar dimer, in coronary angiography regarding early and late adverse reactions. Haemodynamic and electrophysiologic parameters were also analyzed. Results: Visipaque resulted in significantly fewer early adverse contrast medium-related reactions (p<0.05). Visipaque also demonstrated significantly fewer effects on electrophysiologic parameters. Both contrast media reduced systolic and diastolic blood pressures at the 1st injection in the left coronary artery. Late adverse reactions were unusual with both contrast media and occurred only as urticaria with a frequency of 1.7%, which is lower than reported in i.v. studies. One serious adverse reaction, a myocardial infarction in a male patient with severe cardiovascular disease, occurred in the Visipaque group. This event was considered to be procedure- and disease-related rather than related to the type of contrast medium used. Conclusion: We found Visipaque safe for coronary angiography, causing fewer early adverse reactions than Hexabrix and also fewer effects on electrophysiologic parameters. Late adverse reactions seemed to be unusual with intra-arterial administration of contrast media.