Experience of low-dose aminophylline use to relieve minor adverse effects of dipyridamole in patients undergoing stress myocardial perfusion imaging

• Published in: Journal of nuclear cardiology 2014-06, Vol.21 (3), p.563-569
• Main Authors: Lin, Li-Fan, Cheng, Cheng-Yi, Hou, Cheng-Han, Ku, Chih-Hung, Tseng, Neng-Chuan, Shen, Daniel H.Y.
• Format: Article
• Language: English
• Subjects: Adult; adverse effect; Aged; Aged, 80 and over; aminophylline; Aminophylline - administration & dosage; Cardiology; Cardiotonic Agents - administration & dosage; Comorbidity; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Dipyridamole; Dipyridamole - adverse effects; Dose-Response Relationship, Drug; Drug Interactions; Drug-Related Side Effects and Adverse Reactions - epidemiology; Exercise Test - adverse effects; Exercise Test - statistics & numerical data; Female; Humans; Imaging; Incidence; Injections, Intravenous; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Perfusion Imaging - adverse effects; Myocardial Perfusion Imaging - statistics & numerical data; myocardial perfusion imaging: SPECT; Nuclear Medicine; Original Article; pharmacologic stress; Prevalence; Radiology; Radiopharmaceuticals; Retrospective Studies; Risk Factors; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon - adverse effects; Tomography, Emission-Computed, Single-Photon - statistics & numerical data; Treatment Outcome; Vasodilator Agents - adverse effects; Young Adult
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-014-9883-7

Intravenous administration of aminophylline is widely adopted to reverse dipyridamole-related adverse effects (AEs) during stress myocardial perfusion imaging (MPI). The study aimed to investigate the efficacy of lower-dose aminophylline to relieve minor AEs. 2,250 consecutive patients undergoing dipyridamole-stressed MPI were enrolled. Information concerning AE occurrence and dosages of aminophylline was collected to evaluate the efficacy of lower-dose aminophylline. A logistic regression was used to determine independent predictors of dipyridamole-related AE occurrence. No severe AE was noted. Overall mild AE incidence was 37.0% (833/2,250 patients). Initial low-dose (25 mg) aminophylline relieved symptoms in 98.8% of patients with mild AEs (823/833 patients). An extra 25 mg aminophylline sufficed to reverse all such AEs. Mean body mass index (BMI) differed significantly between patients with and without any AE [25.6 vs 25.1 (P = .009)]. There was no significant difference between two subgroups in mean age, male gender prevalence, body height and weight, dipyridamole dose/BMI, or prevalence of significant perfusion defect(s) on MPI. Multivariable logistic regression demonstrated BMI remained the independent predictor of dipyridamole-related AE occurrence (odds ratio 1.028, 95% confidence interval 1.007-1.049, P = .01). Low-dose (≦50 mg, and usually 25 mg) aminophylline seems sufficient to relieve mild dipyridamole-related AEs during stress MPI.