Authors: Mridula Rai Alan W Ahlberg Julianna Marwell Waseem Chaudhary John A Savino Eric L Alter Milena J Henzlova W Lane Duvall
Publish Date: 2016/02/22
Volume: 24, Issue: 2, Pages: 724-734
Abstract
While adenosine and dipyridamole as myocardial perfusion imaging MPI stress agents have literature supporting their safety in the setting of myocardial infarction MI regadenoson does not Studying a high risk cohort of patients with elevated cardiac biomarkers may shed light on potential safety issues of these agents which might also affect lower risk cohortsAll patients who had undergone a clinically indicated stress MPI study at two academic centers from 1/1/2010 through 12/31/2012 with elevated troponin ≤7 days prior to testing were included The primary endpoint was a composite of death nonfatal MI congestive heart failure CHF stroke ventricular arrhythmias atrial fibrillation/flutter or atrioventricular block requiring intervention within 24 h of testingOf the 703 stress MPI studies that met inclusion criteria 360 512 199 283 74 105 9 13 and 61 87 underwent regadenoson dipyridamole adenosine dobutamine and exercise stress respectively The primary endpoint occurred in 11 16 patients with an incidence of 14 n = 5 10 n = 2 14 n = 1 111 n = 1 and 33 n = 2 following regadenoson dipyridamole adenosine dobutamine and exercise stress respectively P = 0137 The adverse events included nonfatal MI in 7 10 patients death in 1 01 patient CHF in 1 01 patient ventricular arrhythmia in 1 01 patient and atrial arrhythmia in 1 01 patient
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