Tolerance and diagnostic accuracy of an abbreviated adenosine infusion for myocardial scintigraphy: A randomized, prospective study

Mark G. Treuth, Guillermo A. Reyes, Zuo Xiang He, Eduardo Cwajg, John J. Mahmarian, Mario S. Verani

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background. The objectives of this study were 2-fold: (1) to determine the tolerance of adenosine perfusion tomography with the use of an abbreviated (3-minute) infusion in comparison to the standard (6-minute) infusion, and (2) to assess the relative diagnostic accuracy of a 3-minute adenosine infusion in patients referred for arteriography. An abbreviated adenosine infusion may decrease the frequency and duration of side effects and be a more cost-effective alternative. Methods and Results. We prospectively randomized 599 patients undergoing adenosine myocardial perfusion tomography to either a 3-minute or 6-minute adenosine infusion at 140 μg/kg per minute. Among the 599 enrolled patients, 142 subsequently underwent coronary angiography. Patients randomized to the 3-minute adenosine infusion tolerated the procedure better than those randomized to the standard infusion (P < .01). Flushing, headache, neck pain, and atrioventricular block were all significantly less frequent (P < .01) with the abbreviated infusion. Moreover, patients receiving the abbreviated infusion had less hypotension and tachycardia (P < .05). The sensitivity of the test for detection of coronary artery disease was 88% for both the 3- and 6-minute infusions. In patients with abnormal scan results, perfusion defect size was slightly larger in those receiving a 6-minute infusion versus those receiving a 3-minute infusion (P = .05). Conclusions. An abbreviated 3-minute adenosine infusion, in combination with perfusion tomography, has similar sensitivity for detection of coronary artery disease and is better tolerated than the standard 6-minute infusion.

Original languageEnglish (US)
Pages (from-to)548-554
Number of pages7
JournalJournal of Nuclear Cardiology
Volume8
Issue number5
DOIs
StatePublished - Jan 1 2001

Keywords

  • Coronary artery disease
  • Myocardial scintigraphy
  • Short adenosine infusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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