title: Prevalence and significance of electrocardiographic changes and side effect profile of regadenoson compared with adenosine during myocardial perfusion imaging.
abstract: BACKGROUND
  Significance of electrocardiogram (EKG) changes associated with regadenoson as well as side effects compared to adenosine in a real world, unselected population is unknown.
  
  
  RESULTS
  Three hundred ninety six consecutive patients undergoing either adenosine or regadenoson-based single-isotope (Technetium 99c) nuclear images were evaluated. A standard form documenting side effects was filled immediately following administration. The EKGs and nuclear scans were reviewed in a blinded-fashion. Commonest symptoms reported were flushing (64%), chest pain (36%) and dyspnea (36%). Flushing and chest pain were significantly more common with adenosine (73% vs. 57%, P < 0.01 and 53% vs. 47%, P = 0.06) and dyspnea more with regadenoson (40% vs. 31%, P = 0.05). Sixty (29%) patients carried a diagnosis of chronic bronchitis or asthma but only 4 (2 with each) required aminophylline. There was no significant correlation between chest pain induced by either agent or ischemia on nuclear imaging. EKG changes occurred infrequently (16% with regadenoson and 10% with adenosine), and had low sensitivity for detecting ischemia (7% for regadenoson and 11% for adenosine).
  
  
  CONCLUSIONS
  EKG changes with adenosine and regadenoson occur infrequently and have low sensitivity for detecting ischemia. Chest pain is frequently induced by both, and is not predictive of ischemia on nuclear imaging.
authors.affiliation: Excela Health System, Excela Health Cardiology, Greensburg, PA, USA ; Department of Developmental Biology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Maliha
authors.initials: M
authors.lastname: Zahid
authors.forename: Aaysha
authors.initials: A
authors.lastname: Kapila
authors.forename: Cecelia E
authors.initials: CE
authors.lastname: Eagan
authors.forename: David A
authors.initials: DA
authors.lastname: Yusko
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Miller
authors.forename: Cheryl D
authors.initials: CD
authors.lastname: Missenda
keywords: Adenosine; Electrocardiographic changes; Regadenoson
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