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

被引:21
作者
Treuth, MG [1 ]
Reyes, GA [1 ]
He, ZX [1 ]
Cwajg, E [1 ]
Mahmarian, JJ [1 ]
Verani, MS [1 ]
机构
[1] Baylor Coll Med, Methodist Hosp, Cardiol Sect, Houston, TX 77030 USA
关键词
short adenosine infusion; myocardial scintigraphy; coronary artery disease;
D O I
10.1067/mnc.2001.116167
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 mug/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.
引用
收藏
页码:548 / 554
页数:7
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