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”

doi:10.1007/S12350-012-9533-X

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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”

Journal Article•DOI•

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”

Rami Doukky¹, Raysa Morales Demori¹, Sidharth Jain¹, Roy Kiriakos², Victor Mwansa², James E. Calvin¹ - Show less +2 more•Institutions (2)

Rush University Medical Center¹, John H. Stroger, Jr. Hospital of Cook County²

07 Mar 2012-Journal of Nuclear Cardiology (Springer-Verlag)-Vol. 19, Iss: 3, pp 448-457

TL;DR: This trial supports the routine administration of IV-aminophylline to reduce the frequency and severity of adverse effects associated with regadenoson-stress.

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About: This article is published in Journal of Nuclear Cardiology.The article was published on 2012-03-07. It has received 52 citations till now. The article focuses on the topics: Regadenoson & Aminophylline.

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Journal Article•DOI•

Adenosine and the Cardiovascular System.

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Allison B. Reiss, David Grossfeld, Lora J. Kasselman, Heather A. Renna, Nicholas A. Vernice, Wendy Drewes, Justin Konig, Steven E. Carsons, Joshua DeLeon - Show less +5 more

01 Oct 2019-American Journal of Cardiovascular Drugs

TL;DR: The effects of adenosine on cell types found in the arterial wall that are involved in atherosclerosis are discussed, use of adenoine and its receptor ligands to limit excess cholesterol accumulation are described and clinically applied anti-platelet effects are explored.

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Abstract: Adenosine is an endogenous nucleoside with a short half-life that regulates many physiological functions involving the heart and cardiovascular system. Among the cardioprotective properties of adenosine are its ability to improve cholesterol homeostasis, impact platelet aggregation and inhibit the inflammatory response. Through modulation of forward and reverse cholesterol transport pathways, adenosine can improve cholesterol balance and thereby protect macrophages from lipid overload and foam cell transformation. The function of adenosine is controlled through four G-protein coupled receptors: A1, A2A, A2B and A3. Of these four, it is the A2A receptor that is in a large part responsible for the anti-inflammatory effects of adenosine as well as defense against excess cholesterol accumulation. A2A receptor agonists are the focus of efforts by the pharmaceutical industry to develop new cardiovascular therapies, and pharmacological actions of the atheroprotective and anti-inflammatory drug methotrexate are mediated via release of adenosine and activation of the A2A receptor. Also relevant are anti-platelet agents that decrease platelet activation and adhesion and reduce thrombotic occlusion of atherosclerotic arteries by antagonizing adenosine diphosphate-mediated effects on the P2Y12 receptor. The purpose of this review is to discuss the effects of adenosine on cell types found in the arterial wall that are involved in atherosclerosis, to describe use of adenosine and its receptor ligands to limit excess cholesterol accumulation and to explore clinically applied anti-platelet effects. Its impact on electrophysiology and use as a clinical treatment for myocardial preservation during infarct will also be covered. Results of cell culture studies, animal experiments and human clinical trials are presented. Finally, we highlight future directions of research in the application of adenosine as an approach to improving outcomes in persons with cardiovascular disease.

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61 citations

Journal Article•DOI•

The safety and tolerability of regadenoson in patients with end-stage renal disease: The first prospective evaluation

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Rami Doukky¹, Maria Octavia Rangel¹, Marwan Wassouf¹, Rizcallah Dick¹, Ammar Alqaid¹, Raysa Morales Demori¹ - Show less +2 more•Institutions (1)

Rush University Medical Center¹

01 Apr 2013-Journal of Nuclear Cardiology

TL;DR: This is the first prospective study to confirm the safety and tolerability of regadenoson (REG)-stress in patients with ESRD.

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45 citations

Additional excerpts

...001 Caucasian 20 (14) 36 (37) African-American 84 (58) 45 (46) Hispanic 39 (27) 11 (11) Primary indication for stress MPI \....
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...001 Definitely 117 (80) 63 (65) Probably 20 (14) 17 (18) Probably Not 6 (4) 13 (13) Absolutely Not 2 (1) 4 (4)...
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...88 Reactive airway disease 20 (14) 15 (16) ....
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...70 Status post-kidney transplantation 21 (14) 1 (1) \....
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Journal Article•DOI•

The prognostic value of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease

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Rami Doukky¹, Ibtihaj Fughhi², Tania Campagnoli², Marwan Wassouf², Amjad Ali² - Show less +1 more•Institutions (2)

John H. Stroger, Jr. Hospital of Cook County¹, Rush University Medical Center²

01 Feb 2017-Journal of Nuclear Cardiology

TL;DR: Regadenoson-stress SPECT-MPI provides a significant prognostic value in patients with end-stage renal disease (ESRD) and is associated with increased rate of the composite endpoint of cardiac death, MI, or CR.

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40 citations

Cites methods from "Attenuation of the side effect prof..."

...The detailed methods and results of these trials were reported elsewhere.(15,16) Briefly, ASSUAGE and ASSUAGE-CKD were two double-blinded, placebo-controlled clinical trials in which patients referred for regadenoson-stress SPECT-MPI were randomized in a 1:1 ratio to receive an intervention of 75 mg of intravenous aminophylline or a matching placebo administered 90 s after radioisotope injection....
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Journal Article•DOI•

Serious and potentially life threatening complications of cardiac stress testing: Physiological mechanisms and management strategies

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Vasken Dilsizian¹, Henry Gewirtz², Nicholas Paivanas³, Anastasia N. Kitsiou, Fadi G. Hage⁴, Nathan E. Crone⁵, Ronald G. Schwartz³ - Show less +3 more•Institutions (5)

University of Maryland, Baltimore¹, Harvard University², University of Rochester Medical Center³, University of Alabama at Birmingham⁴, Johns Hopkins University School of Medicine⁵

15 May 2015-Journal of Nuclear Cardiology

TL;DR: This dissertation aims to provide a history of cardiology at the cellular and molecular level and investigates its role in the development and management of coronary heart disease and stroke.

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40 citations

Cites background from "Attenuation of the side effect prof..."

...A recent study has reported that routine administration of aminophylline to all patients substantially improves symptoms and enhances patient satisfaction to over 90%.(8) Others have found that a small dose (60 mg) of intravenous caffeine citrate or orally self-administered cola, coffee, or tea quickly and safely resolves these mild side effects(60) and is associated with a high level of patient satisfaction....
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Journal Article•DOI•

Regadenoson use in patients with chronic obstructive pulmonary disease: the state of current knowledge.

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Yasmeen Golzar¹, Rami Doukky²•Institutions (2)

John H. Stroger, Jr. Hospital of Cook County¹, Rush University Medical Center²

22 Jan 2014-International Journal of Chronic Obstructive Pulmonary Disease

TL;DR: Regadenoson, a selective A2A adenosine receptor agonist, has gained popularity due to its ease of administration and improved patient experience in the general population and the available data on the safety and tolerability of its use in COPD patients are presented.

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Abstract: Stress testing is challenging in patients with chronic obstructive pulmonary disease (COPD). Functional capacity is generally decreased in this patient population, limiting patients' ability to achieve physiologic stress through exercise. Additionally, due to emphysematous changes, COPD patients tend to have poor acoustic windows that impair the quality and therefore diagnostic accuracy of stress echocardiography techniques. Pharmacologic stress myocardial perfusion imaging (MPI) testing is also problematic, particularly due to the concern for adenosine-induced bronchoconstriction with conventional vasodilator stress agents. Regadenoson, a selective A2A adenosine receptor agonist, has gained popularity due to its ease of administration and improved patient experience in the general population. The literature describing the experience with regadenoson in COPD patients, though limited, is rapidly growing and reassuring. This review summarizes the pharmacology and clinical application of this novel stress agent and presents the available data on the safety and tolerability of its use in COPD patients.

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39 citations

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References

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Journal Article•DOI•

Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart A Statement for Healthcare Professionals From the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association

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Manuel D. Cerqueira, Neil J. Weissman¹, Vasken Dilsizian, Alice K. Jacobs, Sanjiv Kaul¹, Warren K. Laskey, Dudley J. Pennell, John A. Rumberger, Thomas J. Ryan¹, Mario S. Verani - Show less +6 more•Institutions (1)

American Society of Echocardiography¹

29 Jan 2002-Circulation

TL;DR: Attempts to standardize options for all cardiac imaging modalities should be based on the sound principles that have evolved from cardiac anatomy and clinical needs, and selection of standardized methods must bebased on the following criteria.

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Abstract: Nuclear cardiology, echocardiography, cardiovascular magnetic resonance (CMR), cardiac computed tomography (CT), positron emission computed tomography (PET), and coronary angiography are imaging modalities that have been used to measure myocardial perfusion, left ventricular function, and coronary anatomy for clinical management and research. Although there are technical differences between these modalities, all of them image the myocardium and the adjacent cavity. However, the orientation of the heart, angle selection for cardiac planes, number of segments, slice display and thickness, nomenclature for segments, and assignment of segments to coronary arterial territories have evolved independently within each field. This evolution has been based on the inherent strengths and weaknesses of the technique and the practical clinical application of these modalities as they are used for patient management. This independent evolution has resulted in a lack of standardization and has made accurate intra- and cross-modality comparisons for clinical patient management and research very difficult, if not, at times, impossible. Attempts to standardize these options for all cardiac imaging modalities should be based on the sound principles that have evolved from cardiac anatomy and clinical needs.1–3⇓⇓ Selection of standardized methods must be based on the following criteria: An earlier special report from the American Heart Association, American College of Cardiology, and Society of Nuclear Medicine4 defined standards for plane selection and display orientation for serial …

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5,967 citations

Journal Article•DOI•

Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart

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American Society of Echocardiography¹

17 Jun 2002-Journal of Cardiovascular Magnetic Resonance

TL;DR: A remarkable committee was convened: The American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging came to an agreement upon all aspects of nomenclature and anatomic descriptions of the heart.

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Abstract: Nuclear cardiology, echocardiography, cardiovascular magnetic resonance (CMR), cardiac computed tomography (cardiac CT), positron emission computed tomography (PET), and coronary angiography are im...

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3,158 citations

"Attenuation of the side effect prof..." refers methods in this paper

...A quantitative interpretation of MPI was performed using the 17-segment model.(17) Each segment was scored with a standard 5-point scale (0: normal; 1: equivocal; 2: moderate; 3: severe decrease in tracer uptake; 4: absence of detectable radiotracer activity in a segment)....
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Journal Article•DOI•

Stool Form Scale as a Useful Guide to Intestinal Transit Time

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Stephen J. Lewis¹, K. W. Heaton¹•Institutions (1)

Bristol Royal Infirmary¹

01 Sep 1997-Scandinavian Journal of Gastroenterology

TL;DR: This study has shown that a stool form scale can be used to monitor change in intestinal function and such scales have utility in both clinical practice and research.

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Abstract: Background: Stool form scales are a simple method of assessing intestinal transit rate but are not widely used in clinical practice or research, possibly because of the lack of evidence that they a...

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2,345 citations

Journal Article•DOI•

Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: results of the ADVANCE phase 3 multicenter international trial.

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Ami E. Iskandrian¹, Timothy M. Bateman, Luiz Belardinelli, Brent Blackburn, Manuel D. Cerqueira², Robert C. Hendel, Hsiao Lieu, John J. Mahmarian³, Ann Olmsted, S. Richard Underwood⁴, João V. Vitola, Whedy Wang - Show less +8 more•Institutions (4)

University of Alabama at Birmingham¹, Cleveland Clinic², Houston Methodist Hospital³, Imperial College London⁴

01 Sep 2007-Journal of Nuclear Cardiology

TL;DR: This phase 3 trial shows that regadenoson provides diagnostic information comparable to a standard adenosine infusion, and there were no serious drug-related side effects, and regadenoon was better tolerated than adenoine.

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314 citations

"Attenuation of the side effect prof..." refers background or result in this paper

...Unfortunately, the incidence of diarrhea (alone) was not reported in the ADVANCE-MPI trials.(3,4) We were somewhat surprised, however, to observe such high incidence of diarrhea in the placebo arm of this trial (10....
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...In these trials, however, diarrhea was not reported as a ‘‘stand-alone’’ endpoint.(3,4) Since its marketing in 2008, regadenoson has been increasingly popular owing to its favorable tolerability and the convenience of a fixed-dose intravenous bolus administration....
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...Furthermore, the ADVANCE-MPI trials showed a significant increase in the incidence of headache with regadenoson use as compared to adenosine.(3,4) Our trial demonstrated that headache was, not only common but also long lasting, and aminophylline effectively reduced its incidence by an impressive 71% RRR and 22% ARR; which translates to NNT of 5 to prevent one incident of headache....
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Journal Article•DOI•

Myocardial perfusion and function single photon emission computed tomography.

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Christopher L. Hansen, Richard A. Goldstein, Olakunle O. Akinboboye, Daniel S. Berman, Elias H. Botvinick, Keith Churchwell¹, C. David Cooke, James R. Corbett¹, S. James Cullom, Seth T. Dahlberg, Regina S. Druz, Edward P. Ficaro, James R. Galt, Ravi K. Garg, Guido Germano, Gary V. Heller, Milena J. Henzlova, Mark Hyun, Lynne L. Johnson, April Mann, Benjamin D. McCallister, Robert A. Quaife, Terrence D. Ruddy, Senthil Sundaram, Raymond Taillefer, R. Parker Ward, John J. Mahmarian - Show less +23 more•Institutions (1)

University of Michigan¹

01 Nov 2006-Journal of Nuclear Cardiology

TL;DR: Christopher L. Hansen, MD, Richard A. Goldstein, PhD, Olakunle O. Akinboboye, MBBS, MPH, MBA, Daniel S. Botvinick,MD, Keith B. Churchwell, MD and Lynne L. Hyun, CNMT, NCT, RT(N)(R), Lynnel.

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273 citations