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| |  Regadenoson for Myocardial Perfusion Imaging Appears Safe for Patients With Renal Disease: Presented at ACC By Ed Susman ATLANTA -- March 16, 2010 -- The new pharmacologic stress agent regadenoson appears to be safe when administered to for myocardial perfusion imaging in patients with chronic kidney disease, researchers said here at the 59th Annual Scientific Sessions of the American College of Cardiology (ACC). “The haemodynamic results and absence of malignant arrhythmias clearly indicates the tolerability and safety of regadenoson to be similar in control and in chronic kidney disease patients,” said Karthikeyan Ananthasubramaniam, MD, Henry Ford Hospital, Detroit, Michigan. “Regadenoson SPECT [single photon emission computed tomography] can be safely performed in stage 3 to 5 chronic kidney disease nondialysis patients,” he said here on March 15 during his poster presentation. Dr. Ananthasubramaniam said the goal of his study was to determine if there was a danger of atrioventricular block of the heart when the stress test agent is introduced -- especially among patients with evidence of chronic kidney disease as measured by estimated glomerular filtration rate <60 mL/minute. He noted that other agents that create a pharmacological cardiac stress have been known to cause the life-threatening heart rhythm disturbance. The researchers identified 301 consecutive patients with chronic kidney disease who underwent regadenoson SPECT imaging studies. Ten of the patients were classified as having stage 5 renal disease. They were compared with 500 patients with glomerular filtration rates >60 mL/minute who also had regadenoson SPECT studies. About 44% of the patients with chronic kidney disease experienced any arrhythmias compared with 39% of the control group of patients with higher glomerular filtration rates -- a nonsignificant difference. Of those arrhythmias 99% were premature ventricular complexes, and 1% were transient junctional rhythm events. There were no atrioventricular block episodes in either with the low estimated glomerular filtration rate or those with the higher rates, Dr. Ananthasubramaniam said. He said that researchers had hoped that the selective nature of regadenoson would make it a safer drug to use than agents such as adenosine that is nonselective. “This selective coronary vasodilation, rapid onset and termination of action, and single bolus administration makes this drug an ideal choice for a pharmacologic stress agent in both the control and chronic kidney disease patients not on dialysis,” Dr. Ananthasubramaniam said. The patients in the study were administered a standard 400 mcg regadenoson bolus and then a gated Technetium-99m sestamibi SPECT study was performed. The patients in the chronic kidney disease group had a significantly higher prevalence of diabetes, coronary artery disease, and left ventricular ejection fractions <50%. Nevertheless, Dr. Ananthasubramaniam said that the research team could find no statistically significant differences between the 2 groups when it came to occurrence of arrhythmias. “This study should be reassuring to patients and doctors that these tests can be performed safely.” [Presentation title: Safety of Regadenoson as a Pharmacologic Stress Agent for Myocardial Perfusion Imaging in Stage 3, 4 and 5 Chronic Kidney Disease Patients Not on Hemodialysis. Abstract 1206-245]
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