Evidence mapPaperPMID 17826318Full record

Trial reportJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: results of the ADVANCE phase 3 multicenter international trial.

Ami E Iskandrian, Timothy M Bateman, Luiz Belardinelli, Brent Blackburn, Manuel D Cerqueira, Robert C Hendel, Hsiao Lieu, John J Mahmarian, Ann Olmsted, S Richard Underwood and 3 more

4 registry-linked trialsAbstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 165 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
165citing papers in PubMed, 4 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00208312 phase3completednot on this map

A Phase III, Randomized, Double-Blind Study of Intravenous CVT-3146 Versus Adenoscan® in Patients Undergoing Stress Myocardial Perfusion Imaging

TypeinterventionalSponsorGilead SciencesRan2004 to 2005Enrolled787ConditionsCoronary Artery DiseaseArmsRegadenoson, Adenosine
NCT00763035 early_phase1terminatednot on this map

Comparison of Dobutamine and Regadenoson Stress CMR

TypeinterventionalSponsorWake Forest University Health SciencesRan2009 to 2011Enrolled14ConditionsCoronary Artery Disease, Asthma, Chronic Obstructive Pulmonary Disease (COPD), AnginaArmsRegadenoson, Dobutamine
NCT00881218 early_phase1completednot on this map

Feasibility of Detecting Myocardial Ischemia by First-pass Contrast MRI Using Regadenoson

TypeinterventionalSponsorWashington University School of MedicineRan2009 to 2011Enrolled50ConditionsIschemic Heart DiseaseArmsRegadenoson
NCT01161121 phase1completednot on this map

Utilization of Lexiscan (Regadenoson)in the Cardiac Catheterization Lab to Achieve Maximal Hyperemia for Coronary Physiologic Assessment With Fractional Flow Reserve

TypeinterventionalSponsorSt. Louis UniversityRan2010 to 2013Enrolled46ConditionsCoronary Artery DiseaseArmsadenosine, regadenoson
3 · Its place in the literature

Who cites it

165 citing papers in PubMed, 4 syntheses or guidelines pooled it, 342 citations in OpenAlex.

  1. Guideline
  2. Update of the Brazilian Guideline on Nuclear Cardiology - 2020.Arquivos brasileiros de cardiologia · 2020
    Guideline
  3. Incidence of atrioventricular block with vasodilator stress SPECT: A meta-analysis.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019
    Pooled it
  4. The safety and tolerability of regadenoson in patients with end-stage renal disease: the first prospective evaluation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2013
    Pooled it
  5. Trial
  6. Aminophylline and caffeine for reversal of adverse symptoms associated with regadenoson SPECT MPI.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Trial
  7. Trial
  8. Safety and tolerability of intravenous regadenoson in healthy subjects: A randomized, repeat-dose, placebo-controlled study.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Trial
  9. Trial
  10. Regadenoson provides perfusion results comparable to adenosine in heterogeneous patient populations: a quantitative analysis from the ADVANCE MPI trials.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015
    Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Effect of caffeine on adenosine-induced reversible perfusion defects assessed by automated analysis.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012
    Trial
  18. Trial
  19. A randomized, double-blind, placebo-controlled study of the safety and tolerance of regadenoson in subjects with stage 3 or 4 chronic kidney disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012
    Trial
  20. Effect of body mass index on the efficacy, side effect profile, and plasma concentration of fixed-dose regadenoson for myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2011
    Trial

105 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 3 countries.

Ami E IskandrianUniversity of Alabama at Birmingham, Birmingham, AL 35294-0006, USA. aiskand@uab.edu
Timothy M Bateman
Luiz Belardinelli
Brent Blackburn
Manuel D Cerqueira
Robert C Hendel
Hsiao Lieu
John J Mahmarian
Ann Olmsted
S Richard Underwood
João Vitola
Whedy Wang
ADVANCE MPI Investigators
Carolina Veterinary Specialists · USCleveland Clinic · USHouston Methodist · USRoyal Brompton Hospital · GBUniversidade Federal do Paraná · BRUniversity of Alabama at Birmingham · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarlier phase 1 and 2 studies have shown that regadenoson has desirable features as a stress agent for myocardial perfusion imaging. METHODS AND

resultsThis multicenter, double-blinded phase 3 trial involved 784 patients at 54 sites. Each patient underwent 2 sets of gated single photon emission computed tomography myocardial perfusion imaging studies: an initial qualifying study with adenosine and a subsequent randomized study with either regadenoson (2/3 of patients) or adenosine. Regadenoson was administered as a rapid bolus (<10 seconds) of 400 mug. The primary endpoint was to demonstrate noninferiority by showing that the difference in the strength of agreement in detecting reversible defects, based on blinded reading, between sequential adenosine-regadenoson images and adenosine-adenosine images, lay above a prespecified noninferiority margin. Other prospectively defined safety and tolerability comparisons and supporting analyses were also performed. The average agreement rate based on the median of 3 independent blinded readers was 0.63 +/- 0.03 for regadenoson-adenosine and 0.64 +/- 0.04 for adenosine-adenosine-a 1% absolute difference with the lower limit of the 95% confidence interval lying above the prespecified noninferiority margin. Side-by-side interpretation of regadenoson and adenosine images provided comparable results for detecting reversible defects. The peak increase in heart rate was greater with regadenoson than adenosine, but the blood pressure nadir was similar. A summed symptom score of flushing, chest pain, and dyspnea was less with regadenoson than adenosine (P = .013).

conclusionsThis phase 3 trial shows that regadenoson provides diagnostic information comparable to a standard adenosine infusion. There were no serious drug-related side effects, and regadenoson was better tolerated than adenosine.

Indexed as

AdenosinePurinesPyrazolesAdolescentAdultAgedDouble-Blind MethodExercise TestFemaleHumansMaleMiddle AgedReproducibility of ResultsSensitivity and SpecificitySubtraction TechniqueTomography, Emission-Computed, Single-PhotonAdenosinePurinesPyrazolesregadenosonVasodilator Agents

Identifiers

PMID17826318
OpenAlexW2022472954

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.