Comparison of regadenoson and dipyridamole safety profile during stress myocardial perfusion imaging.

INTRODUCTION: The pharmacological stress test with vasodilator agents is an alternative cardiological diagnostic tool for patients with contraindications to the classical stress test provided by physical activity during the single photon emission computed tomography myocardial perfusion imaging. The aim of our study was to compare the frequency of the side effects of regadenoson and dipyridamole during single photon emission computed tomography myocardial perfusion imaging.
METHODS: This retrospective study included data of consecutive 283 patients who underwent pharmacological stress tests in years 2015-2020. The study group consisted of 240 patients who have received dipyridamole and 43 patients who have received regadenoson. The collected data included the patients’ characteristics, the occurrence of side effects (divided into mild: headache, vertigo, nausea, vomiting, dyspnea, chest discomfort, hot flushes, general weakness and severe: bradycardia, hypotension, loss of consciousness) and blood pressure values/measurements.
RESULTS: Overall, complications occurred relatively often (regadenoson: 23.2%, dipirydamol: 26.7%, p=0.639). Procedure discontinuation was necessary in 0.7% of examinations, whereas pharmacological support was necessary in 4.7%. There was no difference in prevalence of mild (regadenoson: 16.2%, dipirydamol: 18.3%, p=0.747) and severe complications (regadenoson: 11.6%, dipirydamol: 15.0%, p=0.563). However, regadenoson has been found to cause a significantly smaller average decrease of systolic blood pressure (regadenoson: -2.6±10.0mmHg, dipirydamol: -8.7±9.6mmHg, p=0.002), diastolic blood pressure (regadenoson: -0.9±5.4mmHg, dipirydamol: -3.6±6.2mmHg, p=0.032), as well as mean arterial pressure (regadenoson: -1.5±5.6 mmHg, dipirydamol: -5.4±6.5mmHg, p=0.001).
DISCUSSION AND CONCLUSION: Regadenoson and dipyridamole presented a similar safety profile during single photon emission computed tomography myocardial perfusion imaging. However, regadenoson has been found to cause significantly smaller decreases in systolic blood pressure, diastolic blood pressure, mean arterial pressure.