Real world experience with regadenoson spect myocardial perfusion imaging: Patient characteristics, safety, and impact of results on clinical management

Document Type

Conference Proceeding

Publication Date

2018

Publication Title

J Nucl Cardiol

Abstract

Introduction: Real-world (RW) experience with regadenoson (REG) in diverse populations is not well documented. The Henry Ford Hospital (HFH) REG registry includes patients with a variety of comorbidities allowing for the evaluation of REG in a large group of unselected patients. Methods: A retrospective, secondary database analysis of patient records and nuclear cardiology reports. Patients age > 18 years who underwent REG-facilitated SPECT testing at HFH (1/09-12/13) were identified. Primary objective was to describe the clinical and demographic characteristics of patients who had undergone REG only or REGWALK (REG + low-level exercise) SPECT. Other endpoints: 90-day downstream impact of REG SPECT results on treatment decisions (secondary); rate of immediate adverse/clinical events occurring between time of SPECT and discharge from nuclear lab (exploratory). Results: Overall, 2126 patients met eligibility criteria (mean age 65.2 years; 50% men; 50% African American, 43% Caucasian); 22 patients (1%) were excluded for receiving adjunct REG as part of exercise SPECT. For the REG only (n = 1318) and REG WALK (n = 786) cohorts, comorbidity, safety, and clinical impact of SPECT are summarized in the Table. SPECT was abnormal in 37% of patients (REG only 39%, REGWALK 34%, P<0.01). Medical management changes were noted, but no difference in diagnostic or interventions in the 90 days after SPECT were observed. Immediate safety analysis showed no deaths following REG SPECT 48 hours after testing. Conclusions: REG SPECT is overall well tolerated and shows excellent short-term safety in RW patient populations, including in those with respiratory diseases. Our data indicate that choice between REG WALK and REG is driven by underlying patient comorbidities and baseline characteristics. Abnormal scans do not necessarily lead to increased downstream testing, reflecting more focus on initial medical management, which is the current trend for management of stable coronary disease.

Volume

25

Issue

4

First Page

1445

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