Περίληψη:
Purpose: To evaluate differences in side-effects and hemodynamic response between men and women undergoing regadenoson-stress SPECT myocardial perfusion imaging (MPI). Methods: The initial population of the study included 858 consecutive patients who underwent regadenoson-stress MPI at our institution. These patients underwent prospective assessment and classification of regadenoson-induced side-effects in six categories and recording of heart rate (HR) and blood pressure (BP) before and after regadenoson administration. From this initial population, after adjustment with 1:1 propensity matching using gender as the dependent variable and age, BMI, diabetes mellitus, hypertension, smoking, presence of coronary artery disease, LVEF, baseline systolic and diastolic blood pressure (BP) and HR, on-going use of cardio-active medications during test, and abnormal MPI scan as independent variables, a population of 279 pairs of opposite gender was formed and studied. Results: Compared with men, women had a significantly higher rate of any side-effect (71% vs. 58%, p = 0.002), chest pain (23% vs. 12%, p < 0.001), gastrointestinal discomfort (20% vs. 12%, p = 0.01), dizziness (12% vs. 5%, p = 0.002), and headache (20% vs. 13%, p = 0.03) and similar rates of dyspnea and other side-effects. Women demonstrated a higher median HR-response compared with men (41% (− 8, 127) vs. 34% (− 5, 106), p = 0.001) while men demonstrated a lower median systolic BP response (− 3% (− 27, 48) vs. 0% (− 36, 68), p = 0.02) compared with women. Conclusions: Gender is independently associated with a differential response to regadenoson with regard to overall side-effects and HR-response. These observations have the potential of important management and prognostic implications respectively. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
Συγγραφείς:
Katsikis, A.
Kyrozi, E.
Manira, V.
Theodorakos, A.
Malamitsi, J.
Tsapaki, V.
Iakovou, I.
Voudris, V.
Kolovou, G.
Koutelou, M.
Λέξεις-κλειδιά:
methoxy isobutyl isonitrile technetium tc 99m; regadenoson; purine derivative; pyrazole derivative; regadenoson, adult; aged; Article; blood pressure; coronary artery disease; dizziness; drug safety; dyspnea; female; gastrointestinal symptom; headache; heart left ventricle ejection fraction; heart rate; hemodynamics; hot flush; human; major clinical study; male; myocardial perfusion imaging; observational study; prospective study; sex difference; side effect; single photon emission computed tomography; systolic blood pressure; thorax pain; treatment response; unspecified side effect; drug effect; heart stroke volume; hemodynamics; middle aged; sexual characteristics; very elderly, Adult; Aged; Aged, 80 and over; Female; Heart Rate; Hemodynamics; Humans; Male; Middle Aged; Myocardial Perfusion Imaging; Purines; Pyrazoles; Sex Characteristics; Stroke Volume; Tomography, Emission-Computed, Single-Photon
