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Published in: Journal of Nuclear Cardiology 2/2013

01-04-2013 | Editorial

Use of regadenoson in end-stage renal disease

Authors: Ami E. Iskandrian, MD, MACC, Fadi G. Hage, MD, FACC, Jaekyeong Heo, MD, FACC

Published in: Journal of Nuclear Cardiology | Issue 2/2013

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Excerpt

Regadenoson has rapidly become the pharmacological stress agent of choice in the United States since its approval by the Food and Drug Administration in April 2008.1-5 The effect of regadenoson on myocardial blood flow is rapid necessitating the injection of radionuclide tracer 30 seconds after its injection as a bolus. The terminal part of the triphasic half-life is not associated with significant drug effect of any sort, which is important as prolonged monitoring of the patient is unnecessary. Almost 57% of the drug is excreted unchanged in the urine, which begs the question of safety in patients with impaired renal function.6,7
Literature
1.
go back to reference Iskandrian AE, Bateman TM, Belardinelli L, Blackburn B, Cerqueira MD, Hendel RC, et al. Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trials. J Nucl Cardiol 2007;14:645-58.PubMedCrossRef Iskandrian AE, Bateman TM, Belardinelli L, Blackburn B, Cerqueira MD, Hendel RC, et al. Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trials. J Nucl Cardiol 2007;14:645-58.PubMedCrossRef
2.
go back to reference Lieu HD, Shryock JC, von Mering GO, Gordi T, Blackburn B, Olmsted AW, et al. Regadenoson, a selective A2A adenosine receptor agonist, causes dose-dependent increases in coronary blood flow velocity in humans. J Nucl Cardiol 2007;14:514-20.PubMedCrossRef Lieu HD, Shryock JC, von Mering GO, Gordi T, Blackburn B, Olmsted AW, et al. Regadenoson, a selective A2A adenosine receptor agonist, causes dose-dependent increases in coronary blood flow velocity in humans. J Nucl Cardiol 2007;14:514-20.PubMedCrossRef
3.
go back to reference Cerqueira MD, Nguyen P, Staehr P, Underwood SR Sr, Iskandrian AE, on behalf of the ADVANCE-MPI Trial Investigators. Effects of age, gender, obesity, and diabetes on the efficacy and safety of the selective A2A agonist regadenoson versus adenosine in myocardial perfusion imaging: Integrated ADVANCE-MPI trial results. J Am Coll Cardiol Imaging 2008;1:307-16.CrossRef Cerqueira MD, Nguyen P, Staehr P, Underwood SR Sr, Iskandrian AE, on behalf of the ADVANCE-MPI Trial Investigators. Effects of age, gender, obesity, and diabetes on the efficacy and safety of the selective A2A agonist regadenoson versus adenosine in myocardial perfusion imaging: Integrated ADVANCE-MPI trial results. J Am Coll Cardiol Imaging 2008;1:307-16.CrossRef
4.
go back to reference Zoghbi GJ, Iskandrian AE. Selective adenosine agonists and myocardial perfusion imaging. J Nucl Cardiol 2012;19:126-41.PubMedCrossRef Zoghbi GJ, Iskandrian AE. Selective adenosine agonists and myocardial perfusion imaging. J Nucl Cardiol 2012;19:126-41.PubMedCrossRef
5.
go back to reference Iskandrian AE, Garcia EV, editors. Nuclear cardiac imaging: Principles and applications. 4th ed. Oxford: Oxford University Press; 2008. Iskandrian AE, Garcia EV, editors. Nuclear cardiac imaging: Principles and applications. 4th ed. Oxford: Oxford University Press; 2008.
6.
go back to reference Gordi T, Frohna P, Sun HL, Wolff A, Belardinelli L, Lieu H. A population pharmacokinetic/pharmacodynamic analysis of regadenoson, an adenosine A2a-receptor agonist, in healthy male volunteers. Clin Pharmacokinet 2006;45:1201-12.PubMedCrossRef Gordi T, Frohna P, Sun HL, Wolff A, Belardinelli L, Lieu H. A population pharmacokinetic/pharmacodynamic analysis of regadenoson, an adenosine A2a-receptor agonist, in healthy male volunteers. Clin Pharmacokinet 2006;45:1201-12.PubMedCrossRef
7.
go back to reference Gordi T, Blackburn B, Lieu H. Regadenoson pharmacokinetics and tolerability in subjects with impaired renal function. J Clin Pharmacol 2007;47:825-33.PubMedCrossRef Gordi T, Blackburn B, Lieu H. Regadenoson pharmacokinetics and tolerability in subjects with impaired renal function. J Clin Pharmacol 2007;47:825-33.PubMedCrossRef
8.
go back to reference Doukky R, Rangel MO, Wassouf M, Dick R, Alqaid A, Demori RM. The safety and tolerability of regadenoson in patients with end-stage renal disease: The first prospective evaluation. J Nucl Cardiol. doi:10.1007/s12350-012-9654-2. Doukky R, Rangel MO, Wassouf M, Dick R, Alqaid A, Demori RM. The safety and tolerability of regadenoson in patients with end-stage renal disease: The first prospective evaluation. J Nucl Cardiol. doi:10.​1007/​s12350-012-9654-2.
9.
go back to reference Rangel MO, Dick R, Wassouf M, Alqaid A, Morales Demori R, et al. Attenuation of the side effect profile of regadenoson: A randomized double-blind placebo-controlled study with aminophylline in patients with severe chronic kidney disease undergoing myocardial perfusion imaging—The ASSUAGE-CKD Trial. J Nucl Cardiol 2012;19:448-57.CrossRef Rangel MO, Dick R, Wassouf M, Alqaid A, Morales Demori R, et al. Attenuation of the side effect profile of regadenoson: A randomized double-blind placebo-controlled study with aminophylline in patients with severe chronic kidney disease undergoing myocardial perfusion imaging—The ASSUAGE-CKD Trial. J Nucl Cardiol 2012;19:448-57.CrossRef
10.
go back to reference Doukky R, Demori RM, Jain S, Kiriakos R, Mwansa V, Calvin JE. Attenuation of the side effect profile of regadenoson: A randomized double-blinded placebo-controlled study with aminophylline in patients undergoing myocardial perfusion imaging. “The ASSUAGE trial”. J Nucl Cardiol 2012;19:448-57.PubMedCrossRef Doukky R, Demori RM, Jain S, Kiriakos R, Mwansa V, Calvin JE. Attenuation of the side effect profile of regadenoson: A randomized double-blinded placebo-controlled study with aminophylline in patients undergoing myocardial perfusion imaging. “The ASSUAGE trial”. J Nucl Cardiol 2012;19:448-57.PubMedCrossRef
11.
go back to reference Hage FG, Smalheiser S, Zoghbi GJ, Perry GJ, Deierhoi M, Warnock D, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol 2007;100:1020-5.PubMedCrossRef Hage FG, Smalheiser S, Zoghbi GJ, Perry GJ, Deierhoi M, Warnock D, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol 2007;100:1020-5.PubMedCrossRef
12.
go back to reference Venkataraman R, Hage FG, Dorfman T, Heo J, Aqel RA, de Mattos AM, Iskandrian AE. Role of myocardial perfusion imaging in patients with end-stage renal disease undergoing coronary angiography. Am J Cardiol 2008;102:1451-6.PubMedCrossRef Venkataraman R, Hage FG, Dorfman T, Heo J, Aqel RA, de Mattos AM, Iskandrian AE. Role of myocardial perfusion imaging in patients with end-stage renal disease undergoing coronary angiography. Am J Cardiol 2008;102:1451-6.PubMedCrossRef
13.
go back to reference Patel AD, Abo-Auda WS, Davis JM, Zoghbi GJ, Deierhoi MH, Heo J, et al. Prognostic value of myocardial perfusion imaging in predicting outcome after renal transplantation. Am J Cardiol 2003;92:146-51.PubMedCrossRef Patel AD, Abo-Auda WS, Davis JM, Zoghbi GJ, Deierhoi MH, Heo J, et al. Prognostic value of myocardial perfusion imaging in predicting outcome after renal transplantation. Am J Cardiol 2003;92:146-51.PubMedCrossRef
14.
go back to reference Hage FG, Dean P, Bhatia V, Iqbal F, Heo J, Iskandrian AE. The prognostic value of the heart rate response to adenosine in relation to diabetes mellitus and chronic kidney disease. Am Heart J 2011;162:356-62.PubMedCrossRef Hage FG, Dean P, Bhatia V, Iqbal F, Heo J, Iskandrian AE. The prognostic value of the heart rate response to adenosine in relation to diabetes mellitus and chronic kidney disease. Am Heart J 2011;162:356-62.PubMedCrossRef
15.
go back to reference Al-Mallah MH, Hachamovitch R, Dorbala S, Di Carli MF. Incremental prognostic value of myocardial perfusion imaging in patients referred to stress single-photon emission computed tomography with renal dysfunction. Circ Cardiovasc Imaging 2009;2:429-36.PubMedCrossRef Al-Mallah MH, Hachamovitch R, Dorbala S, Di Carli MF. Incremental prognostic value of myocardial perfusion imaging in patients referred to stress single-photon emission computed tomography with renal dysfunction. Circ Cardiovasc Imaging 2009;2:429-36.PubMedCrossRef
16.
go back to reference Aggarwal H, Mehta S, Mannon R, Heo J, Iskandrian AE, Hage FG. Heart rate response to adenosine is an independent predictor of long-term mortality in end-stage renal disease. Circulation 2012;126:Number 18036. Aggarwal H, Mehta S, Mannon R, Heo J, Iskandrian AE, Hage FG. Heart rate response to adenosine is an independent predictor of long-term mortality in end-stage renal disease. Circulation 2012;126:Number 18036.
17.
go back to reference Palani G, Husain Z, Salinas RC, Karthikeyan V, Karthikeyan AS, Ananthasubramaniam K. Safety of regadenoson as a pharmacologic stress agent for myocardial perfusion imaging in chronic kidney disease patients not on hemodialysis. J Nucl Cardiol 2011;18:605-11.PubMedCrossRef Palani G, Husain Z, Salinas RC, Karthikeyan V, Karthikeyan AS, Ananthasubramaniam K. Safety of regadenoson as a pharmacologic stress agent for myocardial perfusion imaging in chronic kidney disease patients not on hemodialysis. J Nucl Cardiol 2011;18:605-11.PubMedCrossRef
18.
go back to reference Aljaroudi W, Hermann D, Hage F, Heo J, Iskandrian AE. Safety of regadenoson in patients with end-stage renal disease. Am J Cardiol 2010;105:133-5.PubMedCrossRef Aljaroudi W, Hermann D, Hage F, Heo J, Iskandrian AE. Safety of regadenoson in patients with end-stage renal disease. Am J Cardiol 2010;105:133-5.PubMedCrossRef
19.
go back to reference Ananthasubramaniam K, Weiss R, McNutt B, Klauke B, Feaheny K, Bukofzer S. A randomized, double-blind, placebo-controlled study of the safety and tolerance of regadenoson in subjects with stage 3 or 4 chronic kidney disease. J Nucl Cardiol 2012;19:319-29.PubMedCrossRef Ananthasubramaniam K, Weiss R, McNutt B, Klauke B, Feaheny K, Bukofzer S. A randomized, double-blind, placebo-controlled study of the safety and tolerance of regadenoson in subjects with stage 3 or 4 chronic kidney disease. J Nucl Cardiol 2012;19:319-29.PubMedCrossRef
Metadata
Title
Use of regadenoson in end-stage renal disease
Authors
Ami E. Iskandrian, MD, MACC
Fadi G. Hage, MD, FACC
Jaekyeong Heo, MD, FACC
Publication date
01-04-2013
Publisher
Springer US
Published in
Journal of Nuclear Cardiology / Issue 2/2013
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-012-9658-y

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