Regadenoson is a selective A(2A) receptor agonist that was recently approved by the Food and Drug Administration for
vasodilator stress myocardial perfusion imaging. Because the
drug is cleared by renal excretion, its safety in patients with
end-stage renal disease (
ESRD) needs to be determined. We studied 277 consecutive patients with
ESRD who had undergone
regadenoson stress gated single photon emission computed tomography myocardial perfusion imaging and compared their side effect profile and safety outcome to those of 134 patients with normal kidney function. The
ESRD group included 164 men (59%) and the control group included 73 men (54%; p = NS). The patients with
ESRD were younger than the controls (52 +/- 11 years vs 61 +/- 12 years; p <0.001). The myocardial perfusion imaging findings were abnormal in 53 patients (19%) with
ESRD and in 24 patients in the control group (18%; p = NS). The left ventricular ejection fraction was 57 +/- 12% in the
ESRD group and 64 +/- 12% in the control group (p <0.001). The changes in heart rate and systolic blood pressure (from baseline to peak stress) were 20 +/- 12 beats/min versus 22 +/- 13 beats/min and -11 +/- 24 mm Hg versus -12 +/- 23 mm Hg in the
ESRD and control groups, respectively (p = NS for both). Very few patients in either group reported symptoms during the stress test. No medication-related hospitalizations, serious events, or death occurred in either group within 30 days of the study. In conclusion, this is the first study to document the safety of
regadenoson in a large number of patients with
ESRD. The
drug was well tolerated, and the hemodynamic and side effect profiles were similar to those of patients with normal renal function.