WEDNESDAY, May 21 (HealthDay News) -- Regadenoson performed equally as well as adenosine in myocardial perfusion imaging for detecting ischemia and was better tolerated, researchers report in the May issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
Manuel D. Cerqueira, M.D., of the Cleveland Clinic in Ohio, and colleagues analyzed data from 2,015 patients to compare efficacy, safety and tolerability of stress myocardial perfusion imaging with adenosine versus regadenoson, a selective A2A adenosine receptor agonist that triggers a twofold to threefold rise in myocardial blood flow for three to four minutes. Subjects underwent an adenosine study then were randomized to another with regadenoson or adenosine, and researchers analyzed the agreement of adenosine-adenosine compared to that of adenosine-regadenoson.
Regadenoson demonstrated non-inferiority for detection of ischemia, with similar average agreement rates and similar image quality, the investigators found. Regadenoson had a lower combined symptom score, greater patient comfort, and less frequency of chest pain, flushing and pain in the neck, throat or jaw; however, it was associated with more headache and gastrointestinal discomfort, the report indicates.
"Unlike other agents, regadenoson can be safely administered as a fixed unit bolus because neither its central volume of distribution nor the clearance is significantly affected by body weight," the authors write. "Because of adenosine's ultrashort half-life of less than 10 s (which is too short for adequate tracer uptake), it is not suitable for fixed bolus dosing.
a fixed bolus dose eliminates the need to calculate dose by weight and the need for continuous computerized pump infusion, which may potentially reduce dosing errors."
The trial was sponsored by Cardiovascular Therapeutics, Inc., and Astellas Pharma US. Cerqueira and two co-authors disclosed financial relationships with one or both of these companies.
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