The safety of dipyridamole in patients undergoing myocardial perfusion scintigraphy prior to lung volume reduction surgery.
Patients with end-stage chronic obstructive pulmonary disease (COPD) undergoing lung volume reduction surgery (LVRS) are at high risk of peri-operative cardiac complications, and myocardial perfusion scintigraphy (MPS) is commonly used for risk stratification. This study prospectively assessed the safety of dipyridamole in these patients and compared the incidence of side-effects (particularly dyspnoea) with that in patients undergoing dipyridamole MPS prior to elective non-cardiothoracic surgery. Fifty patients were enrolled: 25 in the LVRS cohort (13 males, 12 females), with a mean age of 65 years and a mean FEV1 of 0.791, and 25 (with no history of asthma or COPD) in the control cohort (14 males, 11 females), with a mean age of 66 years. Fourteen patients (56%) in each group developed side-effects. Dyspnoea was reported by five patients (20%) in the LVRS and two patients (8%) in the control cohort (P=NS). One patient in each cohort developed severe hypotension and bradycardia. Eight (32%) other patients developed minor side-effects in the LVRS cohort compared with 11 (44%) in the control group. All side-effects responded promptly to intravenous aminophylline. In summary, there was a statistically non-significant increase in the incidence of dyspnoea in patients with end-stage COPD and all side-effects responded to aminophylline. Thus, dipyridamole can be used safely in these patients.
Roman
M R
MR
Department of Nuclear Medicine, The Prince of Wales and Sydney Children's Hospital, Randwick, NSW, Australia. nmr@imag.wsahs.nsw.gov.au
Angelides
S
S
Freeman
A P
AP
Parker
M K
MK
da Silva
I
I
D000368:Aged; D000369:Aged, 80 and over; D000628:Aminophylline / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004176:Dipyridamole / Q000009:adverse effects*; D004417:Dyspnea / Q000139:chemically induced / Q000188:drug therapy; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011300:Preoperative Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents / Q000009:adverse effects*
D001993:Bronchodilator Agents; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D000628:Aminophylline; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi