Myocardial perfusion imaging laboratory efficiency with the use of regadenoson compared to adenosine and dipyridamole.
Myocardial perfusion imaging laboratory efficiency with the use of regadenoson compared to adenosine and dipyridamole.
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DOI：
10.3111/13696998.2013.772057
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发表时间：
2013-01-01
影响因子：
2.4
通讯作者：
Boulanger, Luke
中科院分区：
文献类型：
--
作者：
Friedman, Michelle;Spalding, James;Boulanger, Luke
目的：腺苷、潘生丁和瑞格腺苷是心肌灌注成像(MPI)中用于诊断和监测冠状动脉疾病的药物应激剂。临床研究表明，瑞格腺苷具有药理学特性，可通过更广泛的患者使用和更容易的管理要求来简化MPI程序。这项研究评估了与腺苷和双嘧达莫相比，使用瑞格腺苷的操作优势和实验室效率。方法：从2009年6月到7月，对141名在美国心血管成像实验室工作的核医学技术人员进行了网络调查。主要观察指标：描述性统计测量了腺苷、潘生丁和瑞格腺苷的队列。双变量分析比较了进行MPI测试的总体时间和特定于员工的时间。根据医院和非医院环境、手术时间、SPECT摄像机数量和全职同等工作人员的数量(包括护士、核技术专家、内科医生和护士从业者/医生助理)来定义特定地点的亚组。结果：与腺苷和潘生丁相比，瑞格腺苷156(46)分钟进行MPI测试的总时间最短(分别为63和191分钟)。从给药到开始显影的时间，包括剂量计算和输注时间，比腺苷少14.2min，比潘生丁少12.0min。与腺苷和潘生丁相比，与腺苷和潘生丁相比，控制不良事件发生的时间最短，但有少数例外。由于调查实施的性质，可能的回忆偏差可能会限制结果。操作时间上的一些差异可能是由于实验室方案的不同。结论：与腺苷和潘生丁相比，使用瑞格腺苷时，总体节省的时间和按操作能力(工作人员数量、SPECT摄像机数量、操作时间)分层的时间节约转化为更有效地利用实验室资源。与腺苷和潘生丁相比，瑞格腺苷是最有效的药物应激剂。
OBJECTIVE: Adenosine, dipyridamole, and regadenoson are pharmacologic stress agents used in myocardial perfusion imaging (MPI), to diagnose and monitor coronary artery disease. Clinical studies suggest that regadenoson has pharmacologic properties that simplify the MPI procedure through availability to a wider range of patients and easier administrative requirements. This study assesses the operational advantages and laboratory efficiency associated with the use of regadenoson compared to adenosine and dipyridamole.METHODS: A web-based survey of 141 nuclear medicine technologists working in US-based cardiovascular imaging laboratories from June-July 2009.MAIN OUTCOME MEASURES: Descriptive statistics measured the adenosine, dipyridamole, and regadenoson cohorts. Bivariate analyses compared the overall and staff-specific time to conduct an MPI test. The site-specific sub-groups were defined by hospital vs non-hospital setting, hours of operation, number of SPECT cameras, and number of full-time equivalent staff, including nurses, nuclear technologists, physicians, and nurse practitioners/physician assistants.RESULTS: The total time to conduct an MPI test was shortest with regadenoson 156 (46) min compared to adenosine and dipyridamole 182 (63) and 191 (61) min, respectively. Time from regadenoson administration to the start of the imaging session, including dose calculation and infusion time, was 14.2min less than adenosine, and 12.0min less than dipyridamole. The time to manage adverse events was shortest if it occurred with regadenoson compared to adenosine and dipyridamole, with minor exceptions. Due to the nature of survey implementation, possible recall bias may limit the results. Some differences in procedures times may be attributable to differences in laboratories' protocols.CONCLUSIONS: Overall time savings and time savings stratified by operational ability (number of staff, number of SPECT cameras, hours of operation) translate to a more efficient utilization of laboratory resources when using regadenoson compared to adenosine and dipyridamole. Regadenoson is the most efficient pharmacologic stress agent compared to adenosine and dipyridamole.