Gender-related differences in side-effects and hemodynamic response to regadenoson in patients undergoing SPECT myocardial perfusion imaging

Katsikis, Athanasios; Kyrozi, Elena; Manira, Vasiliki; Theodorakos, Athanasios; Malamitsi, J.; Tsapaki, Virginia; Iakovou, Ioannis; Voudris, Vasilios; Kolovou, Genovefa; Koutelou, Maria

doi:10.1007/s00259-019-04463-9

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…A recent study by Katsikis et al [15] demonstrated that gender is independently associated with a differential response to regadenoson with regard to overall side effects and heart rate response. Similarly, a multicenter dipyridamole study by Lette et al [16] showed that female sex and age younger than 70 years were predictors, among a few others, for chest pain and minor noncardiac side effects.…”

Section: Discussionmentioning

confidence: 99%

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Safety and tolerability of regadenoson compared with dipyridamole in myocardial perfusion imaging in patients scheduled to undergo medium to high-risk noncardiac surgery: a randomized controlled study

Stavrou

Polytarchou

Giannopoulou

et al. 2021

Nuclear Medicine Communications

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Objective Regadenoson is the first Food and Drug Administration-approved selective A2A adenosine receptor agonist used in myocardial perfusion imaging. Its main benefits are its simplified and brief protocol, along with the ability to be administered safely in patients with asthma or chronic obstructive pulmonary disease of moderate severity. This study aims to identify any potential benefits of regadenoson, regarding the frequency of adverse reactions and its tolerability, over dipyridamole. Methods This is a randomized controlled study of 200 patients scheduled for medium to high-risk noncardiac surgery, of whom 100 were stressed with regadenoson (study group) and the rest with dipyridamole (control group). Results A greater proportion of adverse reactions was recorded in the regadenoson group as compared to the dipyridamole group (53 vs. 36%; P = 0.023), though the duration of most adverse reactions was shorter in the regadenoson group. Dyspnea (P < 0.001) and gastrointestinal disturbances (P = 0.001) were significantly more frequent in the regadenoson group. The use of aminophylline in patients who developed any adverse events was similar in the two groups (P > 0.05). When multiple regression analyses were performed, differences in adverse reactions between the two groups were no longer significant (odds ratio = 1.96; 95% confidence interval, 0.88–3.25; P = 0.11). Conclusion In our group of patients scheduled for myocardial perfusion imaging for preoperative assessment, the two agents, regadenoson and dipyridamole, have no significant differences in the frequency of mild adverse reactions and in aminophylline use, with regadenoson also having the advantage of faster symptom resolution. Nevertheless, dipyridamole can be considered as a well-tolerated and low-cost alternative.

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Section: Discussionmentioning

confidence: 99%

“…A recent study by Katsikis et al . [15] demonstrated that gender is independently associated with a differential response to regadenoson with regard to overall side effects and heart rate response. Similarly, a multicenter dipyridamole study by Lette et al .…”

Section: Discussionmentioning

confidence: 99%

Safety and tolerability of regadenoson compared with dipyridamole in myocardial perfusion imaging in patients scheduled to undergo medium to high-risk noncardiac surgery: a randomized controlled study

Stavrou

Polytarchou

Giannopoulou

et al. 2021

Nuclear Medicine Communications

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“…Hence, further important parameters associated with side effects present with sex and age. Women demonstrate a higher median BPM associated with a significantly higher rate of side effects compared with men ( 26 ). Regarding the frequency of side effects, the present study was consistent with previously published work ( 21 ) where the presence of adverse events like chest pain, tachycardia, and hypotension was similar to those reported in the present study.…”

Section: Discussionmentioning

confidence: 99%

Adenosine vs. regadenoson for stress induction in dynamic CT perfusion scan of the myocardium: A single‑center retrospective comparison

Gibarti¹,

Murín²,

Huňavý³

et al. 2023

Exp Ther Med

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Cardiac computed tomography (CT) angiography offers several approaches to determine the hemodynamic severity of coronary artery obstruction. Dynamic myocardial perfusion is based on serial CT imaging of contrast flow into the myocardium and calculation of absolute myocardial perfusion rates. East-Slovak Institute of Cardiovascular Diseases has been the first center in Slovakia intensively using this modern technique to increase the quality level of non-invasive diagnosis of symptomatic patients with a low to moderate pre-test probability of ischemic heart disease. The present study included 46 patients with a mean age of 64 years (33 men and 13 women). Prior to the CT study, myocardial stress was pharmacologically (adenosine, n=15 and regadenoson, n=31) induced by vasodilatation of the coronary arteries. Hemodynamic parameters (myocardial blood flow) were evaluated in all patients following successful CT perfusion without complications, allergic reaction or other severe side effects. The present study revealed that regadenoson increased the heart rate following infusion with a higher magnitude compared with adenosine. Moreover, the effect of regadenoson was independent of patient's body mass index and was associated with a lower incidence of mild adverse effects. The present study provided further clinical evidence for a more wider use of regadenoson over adenosine.

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“…Stress myocardial body flow and myocardial flow reserve were not different between the groups (2.2±0.6 vs. 2.1±0.6 mL/min/g, p=0.39, and 2.9±0.8 vs. 2.8±0.7, p=0.31, respectively). If we consider the most common side effects of regadenoson, in a study conducted by Katsikis et al ( 10 ), in the group of patients who underwent the MPI stress test, 197 of 279 women (71%) and 162 of 279 men (58%) experienced side effects of regadenoson. The following side effects occurred more frequently in women: chest pain (65 of 279, 23% versus 33 of 279, 12%, p=<0.001), gastrointestinal discomfort (55 of 279, 20% versus 33 of 279, 12%, p=0.01) dizziness (35 of 279, 12% versus 14 of 279, 5%, p=0.002) and headache (56 of 279, 20% versus 37 of 279, 13%, p=0.03) respectively in women and men.…”

Section: Discussionmentioning

confidence: 99%

“…The following side effects occurred more frequently in women: chest pain (65 of 279, 23% versus 33 of 279, 12%, p=<0.001), gastrointestinal discomfort (55 of 279, 20% versus 33 of 279, 12%, p=0.01) dizziness (35 of 279, 12% versus 14 of 279, 5%, p=0.002) and headache (56 of 279, 20% versus 37 of 279, 13%, p=0.03) respectively in women and men. Other adverse effects appear to be unrelated to gender ( 10 ) In another study, the most common side effects of regadenoson were: dyspnea (149 of 232 patients, 64%), headache (45 of 232, 19%), and chest pain (39 of 232, 17%). Three patients (1.3%) required administration of pharmaceuticals or hemodynamic support to relieve their symptoms.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Regadenoson and Dipyridamole Safety Profiles During Stress Myocardial Perfusion Imaging

Roczniak¹,

Bączalska²,

Kanclerz³

et al. 2023

Mirt

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Objectives: The pharmacological stress test with vasodilator agents is an alternative cardiological diagnostic tool for patients with contraindications to the classical stress test provided by physical activity during single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). The study compared the frequency of the side effects of regadenoson and dipyridamole during a SPECT MPI. Methods: This retrospective study included data of 283 consecutive patients who underwent pharmacological stress tests in years 2015-2020. The study group consisted of 240 patients who had received dipyridamole and 43 patients who had received regadenoson. The collected data included the patients’ characteristics, the occurrence of side effects (divided into mild: headache, vertigo, nausea, vomiting, dyspnea, chest discomfort, hot flushes, general weakness and severe: bradycardia, hypotension, loss of consciousness), and blood pressure values/measurements. Results: Overall, complications occurred relatively often (regadenoson: 23.2%, dipirydamol: 26.7%, p=0.639). Procedure discontinuation was necessary in 0.7% of examinations, whereas pharmacological support was necessary in 4.7%. There was no difference in the prevalence of mild (regadenoson: 16.2%, dipirydamol: 18.3%, p=0.747) and severe complications (regadenoson: 11.6%, dipyridamole: 15.0%, p=0.563). However, regadenoson has been found to cause a significantly smaller mean decrease of systolic blood pressure (SBP) (regadenoson: -2.6±10.0 mmHg, dipyridamole: -8.7±9.6 mmHg, p=0.002), diastolic blood pressure (DBP) (regadenoson: -0.9±5.4 mmHg, dipyridamole: -3.6±6.2 mmHg, p=0.032), as well as mean arterial pressure (MAP) (regadenoson: -1.5±5.6 mmHg, dipyridamole: -5.4±6.5 mmHg, p=0.001). Conclusion: Regadenoson and dipyridamole presented a similar safety profile during SPECT MPI. However, regadenoson has been found to cause significantly smaller decreases in SBP, DBP, and MAP.

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Gender-related differences in side-effects and hemodynamic response to regadenoson in patients undergoing SPECT myocardial perfusion imaging

Cited by 7 publications

References 27 publications

Safety and tolerability of regadenoson compared with dipyridamole in myocardial perfusion imaging in patients scheduled to undergo medium to high-risk noncardiac surgery: a randomized controlled study

Safety and tolerability of regadenoson compared with dipyridamole in myocardial perfusion imaging in patients scheduled to undergo medium to high-risk noncardiac surgery: a randomized controlled study

Adenosine vs. regadenoson for stress induction in dynamic CT perfusion scan of the myocardium: A single‑center retrospective comparison

Comparison of Regadenoson and Dipyridamole Safety Profiles During Stress Myocardial Perfusion Imaging

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