Safety and Cost Effectiveness of High-Osmolality as Compared with Low-Osmolality Contrast Material in Patients Undergoing Cardiac Angiography

NUMEROUS studies have documented that in the performance of cardiac angiography, fewer hemodynamic and electrophysiologic changes result from the use of a nonionic, low-osmolality contrast agent than from the use of a high-osmolality contrast agent. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 A few studies have suggested that high-osmolality agents that bind calcium avidly cause more hemodynamic and electrophysiologic perturbations than those that bind calcium less avidly. 17 18 19 Considerable controversy remains, however, about the use of the two types of contrast agents in cardiac angiography, because those with low osmolality are substantially more expensive than those with high osmolality. The use of 200 ml of a high-osmolality contrast . . .