Abstract
Regadenoson is a pharmacological stress agent that has been widely used since its approval by the Food and Drug Administration (FDA) in 2008. For many years, dipyridamole and adenosine, which are non-selective adenosine receptor agonists, were more popular. However, these agents are less preferred now due to their undesirable adverse effects as compared to regadenoson. In the ADVANCE (ADenoscan Versus regAdenosoN Comparative Evaluation) phase 3 clinical trial, regadenoson demonstrated non-inferiority to adenosine for detecting reversible myocardial ischemia. This review summarizes the clinical utilities of regadenoson as the most widely used pharmacological stress agent. Moreover, the use of regadenoson has been documented in specific patient populations. Although regadenoson has established safety and efficacy in most patients with chronic diseases, there are equivocal results in the literature for other chronic diseases. It is warranted to highlight that the use of regadenoson has not been studied in patients of low socioeconomic class; it is a condition that carries a significant burden on the cardiovascular system.
Highlights
BackgroundThe main idea behind stress testing is to assess the extent and adequacy of the ability of the coronary circulation to augment flow, reflecting coronary flow reserve (CFR)
Risk is determined by the American College of Cardiology Foundation/American Heart Association’s (ACCF/AHA) guidelines for stable ischemic heart disease or the Diamond and Forrester score to assess the pretest probability of coronary artery disease [2]
Based on the above-mentioned reports, it is concluded that the use of regadenoson is safe for use in patients with reactive airway diseases irrelevant of the severity of the condition
Summary
BackgroundThe main idea behind stress testing is to assess the extent and adequacy of the ability of the coronary circulation to augment flow, reflecting coronary flow reserve (CFR). Dobutamine, an inotropic direct agonist of mainly B1 receptors, affects CFR indirectly through increasing flow demand, affecting wall motion and resulting in ST-depression. It can replace exercise stress testing in patients who cannot exercise. In contrast to exercise and dobutamine, these agents induce perfusion heterogeneity in stenosed segments rather than inducing flow demand and subsequent ischemia As a result, these agents need to be coupled with myocardial perfusion imaging [3].
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