Abstract
PurposeRegadenoson was approved for clinical use in Europe in 2011. Since then, it has become the default form of stress at our institution. We have assessed the side-effect profile and tolerability of regadenoson in patients undergoing clinically indicated myocardial perfusion scintigraphy between July 2011 and July 2012.MethodsClinical, stress and imaging data were recorded prospectively. Symptoms during stress were recorded and defined as mild, moderate or severe. An adverse event was defined as any symptom that persisted for more than 30 min or that required investigation or treatment.ResultsOf 1,764 consecutive patients, 1,581 (90 %) received regadenoson combined with submaximal exercise unless contraindicated. Symptoms were common (63 %) but transient and well-tolerated. The severity of symptoms was recorded in most patients as mild (84 %). Dyspnoea (36 %) and chest discomfort (12 %) were the commonest side effects. Adverse events were reported in eight patients (0.5 %), thought to be vasovagal in seven of these. All patients recovered fully without sequelae. There were no deaths, myocardial infarction or hospital admissions. Regadenoson stress was performed in 206 patients (12 %) with asthma or chronic obstructive pulmonary disease (COPD) without bronchospasm or any other major side effect.ConclusionWe studied the symptom profile of regadenoson in the largest European cohort to date. Regadenoson combined with submaximal exercise was well tolerated, notably also in patients with asthma or COPD. The majority of regadenoson-related adverse events were vasovagal episodes without sequelae.
Highlights
Dynamic exercise is the preferred form of stress for myocardial perfusion scintigraphy (MPS), many patients are unable to exercise maximally and pharmacological stress is common [1]
The severity of symptoms was recorded in most patients as mild (84 %)
Regadenoson stress was performed in patients (12 %) with asthma or chronic obstructive pulmonary disease (COPD) without bronchospasm or any other major side effect
Summary
Dynamic exercise is the preferred form of stress for myocardial perfusion scintigraphy (MPS), many patients are unable to exercise maximally and pharmacological stress is common [1]. Pharmacological stress is the default form of stress because most patients have already been considered for or have undergone an exercise ECG. An efficient and effective way of stressing coronary function in this setting is with the use of vasodilators. Adenosine and dipyridamole are both potent primary coronary vasodilators with a nonselective action, which explains the side effects commonly associated with these agents [2,3,4,5,6,7,8,9]. Regadenoson is the only one approved for clinical use by the Food and Drug Administration. Approval was granted by the European Medicines Agency in 2010 and by the Royal Brompton & Harefield NHS Foundation Trust
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