The effects of regadenoson in patients diagnosed with end stage renal disease

Objectives Lexiscan (regadenoson) is a pharmacologic stress agent used in myocardial perfusion imaging for patients unable to be stressed sufficiently with exercise stress. Because 57% of regadenoson is excreted in urine as an unchanged drug, we investigated the effects of regadenoson in patients diagnosed with End Stage Renal Disease compared to a normal population study.

Methods We reviewed regadenoson MPI stress test performed on all 200 End Stage Renal Disease patients at one institution over one year's time. We compared the statistics of these patients to the study data collected in a regadenoson clinical trial. Using a two-tailed two-proportion Z-test, we examined the differences between the populations and the effects of regadenoson with a 95% confidence interval.

Results When comparing the regadenoson clinical trial (N=1337) to the ESRD patient data (N=200), we found the population statistics to be significantly different, including race and gender. More significantly, the percentages of patients who reported having symptoms was statistically different between the two studies. The general clinical trial of regadenoson reported 80% of patients having symptoms, while 88% of ESRD patients reported symptoms. The most common symptom in both studies, dyspnea, was much more common in the ESRD study (67%) than the clinical tiral (28%). Aminophylline was also administered to ESRD patients more often than to the clinical trial members (11% vs. 3%, respectively).

Conclusions The data we collected show that the symptoms experienced by ESRD patients are statistically different than the normal population members of the regadenoson clinical trial. Because an evaluation of ESRD patients has not been completed by the company distributing regadenoson, these findings should be investigated further

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