Abstract | BACKGROUND: METHODS AND RESULTS: In a multicenter, randomized, single-blind, 2-arm crossover trial, 240 patients underwent 2 single photon emission computed tomographic (SPECT) imaging studies in random order, first after pharmacological stress with adenosine and a second study with the selective adenosine A2A receptor agonist binodenoson, using 1 of 4 dosing regimens. Safety, tolerability, and SPECT image concordance between the 2 agents were examined. Exact categorical agreement in the extent and severity of reversible perfusion defects ranged from 79% to 87%, with kappa values from 0.69 to 0.85, indicating very good to excellent agreement between binodenoson and adenosine. The risk of any safety event/side effect was significantly lower with any dose of binodenoson than with adenosine (P< or =0.01) because of a dose-related reduction in subjective side effects, as objective events were infrequent. There was a reduction in the severity of chest pain, dyspnea, and flushing in all binodenoson doses compared with adenosine (P<0.01), and the magnitude of severity reduction was dose-related. CONCLUSIONS: The selective adenosine A2A receptor agonist binodenoson results in an extent and severity of reversible perfusion defects on SPECT imaging similar to nonselective adenosine receptor stimulation, accompanied by a dose-related reduction in the incidence and severity of side effects.
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Authors | James E Udelson, Gary V Heller, Frans J Th Wackers, Andrew Chai, David Hinchman, Patrick S Coleman, Vasken Dilsizian, Marcello DiCarli, Rory Hachamovitch, James R Johnson, Richard J Barrett, Raymond J Gibbons |
Journal | Circulation
(Circulation)
Vol. 109
Issue 4
Pg. 457-64
(Feb 03 2004)
ISSN: 1524-4539 [Electronic] United States |
PMID | 14734517
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Adenosine A2 Receptor Agonists
- Vasodilator Agents
- Adenosine
- binodenoson
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Topics |
- Adenosine
(adverse effects, analogs & derivatives)
- Adenosine A2 Receptor Agonists
- Aged
- Coronary Artery Disease
(diagnostic imaging)
- Coronary Circulation
- Cross-Over Studies
- Dose-Response Relationship, Drug
- Female
- Humans
- Male
- Perfusion
(methods)
- Tomography, Emission-Computed, Single-Photon
(methods)
- Vasodilator Agents
(adverse effects)
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