Objective To investigate the efficacy and safety of regadenoson injection as cardiac stress medicine. It was compared with adenosine injection by using radionuclide myocardial perfusion imaging (MPI) to diagnose coronary disease. Coronary angiography (CAG) was the standard used for this study.

Methods Forty-two subjects with suspected coronary heart disease who were admitted in the First Hospital of Shanxi Medical University from September 2017 to October 2018 were retrospectively analyzed. All subjects were randomly divided into two groups, namely, regadenoson group (8 males; 9 females; age: 59.83±7.88 years old) and adenosine group (12 males; 13 females; age: 56.32±7.34 years old). All subjects underwent rest MPI and stress MPI. Regadenoson and adenosine were injected as medicines. All subjects underwent CAG within 2 weeks. The diagnostic efficacy of regadenoson and adenosine were compared with the results of CAG, which was defined as the gold standard. Adverse reactions were also observed for the two drugs. Two sample t-test, paired t-test or analysis of variance, and Wilcoxon Z rank sum test were used to compare measurement data. Two sample McNemar test or Fisher's exact test were used to measure data. Kappa test was used to test the consistency of the two groups.

Results There were no statistically significant difference between the two groups of general data, the positive rate and the degree of stenosis (t=−1.503−1.201, Z=−1.346−−0.228, Fisher's exact test, all P>0.05). With the results of CAG as the gold standard, the diagnosis sensitivity of regadenoson MPI was 70.00% (7/10), specificity was 87.80% (36/41), positive predictive value was 58.33% (7/12), negative predictive value was 92.31% (36/39), and accuracy was 84.31% (41/51). The sensitivity of adenosine MPI was 71.43% (10/14), specificity was 86.89% (53/61), positive predictive value was 55.56% (10/18), negative predictive value was 92.98% (53/57), and accuracy was 84.00% (63/75). No obvious statistically significant difference for each value was found between the two drugs (Fisher's exact test, all P=1.00). The consistency was moderate between the two groups of drugs and CAG (κ=0.537, 0.525, respectively, both P<0.001). The side effects were mild and transient. No obvious statistically significant difference (Fisher's exact test, all P>0.05) was found between the two groups in terms of adverse reactions, such as blushing, chest pain, chest tightness, dyspnea, dizziness, headache, nausea, and palpitation. Statistically significant difference was only found for abdominal discomfort (Fisher's exact test, P=0.044).

Conclusion Regadenoson injection is similar in terms of efficacy and safety when compared with the injection drug load of adenosine according to the results of myocardial perfusion imaging.