Demographic Analysis of Dipyridamole-Induced Adverse Reaction in Patients Receiving Myocardial Perfusion Scans in Taiwan

Abstract

Background: Intravenous dipyridamole is a commonly used stress method for myocardial perfusion scintigraphy. The reported frequency of adverse effects varied widely and the frequency of adverse effects in Taiwan population has not been investigated. In addition, no literature has extensively studied the risk factors of adverse effects after infusion of dipyridamole. The aim of this study is to investigate the frequency of adverse effects following infusion of dipyridamole for myocardial perfusion scintigraphy. Also, the demographic factors for developing adverse effects after dipyridamole infusion will be analyzed. Methods: We retrospectively reviewed the medical charts of adult patients received dipyridamole-stress myocardial perfusion scintigraphy from July 2012 till November 2013. The patient's blood pressure and pulse during the exam, electrocardiography report, past medical history, height, weight, age, gender, post-infusion adverse effects, early use of aminophylline and coronary angiography after the exam were recorded. We calculated the frequency of each adverse effect and analyzed the possible risk factors for developing more adverse effects by generalized linear model. Results: There were totally 135 patients enrolled. Among all the patients, 90 (66.7%) patients experienced at least one adverse effect. Dizziness was the most common adverse effect (52.6%), followed by headache (44.4%) and chest pain (42.2%). There were 19 (14.1%) patients required early aminophylline administration. After fitting generalized linear model, male was significantly correlated with less adverse effect (β = -1.425, CI = -2.443 to -0.407, P = 0.006) and old age showed a trend for less adverse effect with marginal significance (β = -0.040, CI = -0.087 to 0.008, P = 0.099). For the usage of aminophylline, there were 12 (17.6%) of female required early aminophylline injection and there were 7 (10.4%) male required early aminophylline use. The mean age for routine aminophylline administration and early aminophylline administration were 66.2 ± 10.4 and 61.3 ± 10.5 respectively (P = 0.057). Conclusion: The frequency of dipyridamole-induced adverse effect is not low in Taiwan. Female and younger patients are prone to develop more dipyridamole-induced discomforts and more frequently need early aminophylline administration. Although dipyridamole is still a safe stress method, alternative stress method can be suggested for female and younger patients to avoid or reduce their discomforts.