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M: Effective C: 55 Specific Ways to ImproveAn algorithm was developed to classify patients as being at high or low risk for an event based on patient age, New York Heart Association class, history of a prior contrast reaction, and left ventricular end-diastolic pressure. Application of this algorithm for selective use of low-osmolality agents only for high-risk patients to a theoretical population of 1000 patients reduced contrast agent costs 66 without increasing the frequency of contrast agent-related adverse events. CONCLUSIONS. The advantages of low-osmolality contrast agents are clinically important in patients with severe heart disease but are.