Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Αντώνιος Μανώλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Πάντος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τσιούφης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Π. Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σοφία Χατζηϊωάννου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνα Αγγέλη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιορδάνης Μουρούζης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η ρεγαδενοσόνη (regadenoson) ως φαρμακολογικός παράγοντας κόπωσης για τη σπινθηρογραφική απεικόνιση της αιμάτωσης του μυοκαρδίου σε ασθενείς, υποψήφιους για ενδιάμεσου έως υψηλού κινδύνου μη-καρδιακή επέμβαση: Συγκριτική μελέτη με διπυριδαμόλη
Translated title:
Regadenoson as a pharmacologic stress agent for scintigraphic myocardial perfusion imaging in patients candidates for intermediate-to-high-risk non-cardiac surgery: A comparative study with dipyridamole
Summary:
Introduction: Dipyridamole is the oldest coronary vasodilator approved by the Food and Drug Administration (FDA), used for pharmacologic stress during myocardial perfusion scintigraphy. It indirectly causes vasodilation by increasing circulating adenosine levels. Regadenoson, on the other hand, is the first FDA-approved selective agonist for A2A adenosine receptors, responsible for coronary vasodilation. 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. The present 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 non-cardiac surgery, of which 100 have been 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%), although the duration of most 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 presented any adverse reactions was similar in the two groups (p>0,05). After multiple logistic regression analysis, differences in the frequency of adverse reactions, taken as a whole, 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, had no significant differences in the frequency of mild adverse reactions and aminophylline administration, with regadenoson also having the advantage of faster symptom resolution. Nevertheless, dipyridamole can still be considered as a low-cost and safe alternative.
Main subject category:
Health Sciences
Keywords:
Myocardial perfusion imaging, Pharmacologic stress, Regadenoson. Dipyridamole, Adverse reactions
Number of references:
119
