Comparative study of the safety of regadenoson between patients with mild/moderate chronic obstructive pulmonary disease and asthma

Abstract

This study showed a good safety profile in our series of COPD and asthma patients undergoing MPI. Regadenoson was well tolerated by all patients, with dyspnoea, headache and feeling hot showing differences between groups.

Myocardial perfusion imaging with regadenoson stress in advanced lung disease

“…Similar results have been seen in observational studies in patients with lung disease undergoing MPI for evaluation of CAD. 14,15 In these studies including 228 and 116 patients, no clinically apparent bronchospasm or exacerbation of lung disease was observed immediately after regadenoson infusion. In all of the above mentioned studies, the severity of the lung diseases has been limited to mild or moderate in the majority of patients.…”

Theophylline and Caffeine as Alternatives During an Aminophylline Shortage

“…2 Dynamic exercise is preferred for inducing coronary hyperemia during a cardiac stress test; however, pharmacological agents may be used in patients with contraindications or intolerance to exercise stress testing. 3 The American Society of Nuclear Cardiology (ASNC) imaging guidelines for single-photon emission computed tomography (SPECT) nuclear cardiology procedures: stress, protocols, and tracers (2016) discuss 4 agents for use in pharmacological stress testing: adenosine, regadenoson, dipyridamole, and dobutamine. 2 The first 3 agents are coronary vasodilators.…”

Regadenoson use in patients with chronic obstructive pulmonary disease: the state of current knowledge

“…Combination testing with low-level exercise (1.7 mph, 0% grade) is recommended by the American Society of Nuclear Cardiology practice guidelines based on data that has shown that low-level exercise during adenosine MPI appears to decrease adverse effects, improve patient acceptance and image quality, and may increase the sensitivity for detecting perfusion defects 33,34. In order to further investigate the role of combination testing in patients with underlying lung disease, Garcia et al5 conducted an observational study of 116 unselected patients with mild/moderate COPD (n=67) or asthma (n=49) who underwent pharmacologic stress MPI with regadenoson in combination with low-level treadmill exercise. There was a higher incidence of dyspnea in COPD than in asthma patients (40.3% vs 22.4%; P <0.05), while asthma patients reported more headache and feeling hot (6% vs 18.4% and 10.4% vs 26.5%, respectively; P <0.05).…”

“…There was a higher incidence of dyspnea in COPD than in asthma patients (40.3% vs 22.4%; P <0.05), while asthma patients reported more headache and feeling hot (6% vs 18.4% and 10.4% vs 26.5%, respectively; P <0.05). Adverse events were self-limited, except in three patients who suffered persistent dyspnea (2 of 67 COPD patients; 1 of 49 asthma patients) requiring theophylline administration 5. Of note, the inclusion of COPD or asthma patients was based on medical history, and patients with severe COPD/asthma or active bronchoconstriction based on physical exam were excluded.…”

“…Dobutamine, a beta-receptor agonist, is considered safe in COPD patients. Unfortunately, it is less effective at increasing coronary blood flow, associated with a higher incidence of adverse events, requires more time for protocol completion, and is therefore considered an inferior MPI stress agent 3,5–7…”