Management of CAD

Management of CAD includes lifestyle changes, medical therapies, medical procedures and surgery, in addition to cardiac rehabilitation (Figure 2).4–6

Myocardial perfusion imaging

SPECT MPI performed during stress and at rest is an established method for diagnosing CAD, assessing risk of future cardiac events and informing treatment decisions.1

Mode of Action

Rapiscan® (regadenoson) is the first and only selective A2A adenosine receptor agonist licensed for cardiac functional imaging. 1

Easy to administer

Rapiscan is delivered into a single, fixed dose with no need for infusion pump and weight-based dosing adjustment.

Tolerability

Well tolerated, with adverse events mostly mild and transient.1 Several studies suggest that Rapiscan has a favorable side-effect profile in comparison with adenosine.1,2?

Administration in asthmatic and COPD patients

Rapiscan can be used in patients with pulmonary conditions, based on data derived from MPI clinical settings.
case studies demonstrating the use of rapiscan in the measurement of ffr
Rapiscan is a selective A2A receptor agonist approved for the measurement of FFR.1 The following two case studies illustrate the efficacy and tolerability of Rapiscan in the measurement of FFR when evaluating the functional significance of stenosis in patients with suspected CAD.

Case study 1

Case 1: FFR using Rapiscan in a 44-year-old female patient with stenosis and angina on moderate exertion

Case study 2

Case 2: FFR using Rapiscan in a 70-year-old male patient with stenosis in the LAD
Case study courtesy of Professor Nico Pijls

Feature List

  1. Grech ED. BMJ 2003; 326: 1027.
  2. European Heart Network. European Cardiovascular Disease Statistics 2017. Available at: www.ehnheart.org/cvd-statistics.html (accessed June 2019)
  3. Gheorghiade M et al. Circulation 2006; 114: 1202–1213.
  4. Montalescot G et al. Eur Heart J 2013; 34: 2949–3003.
  5. National Heart, Lung, and Blood Institute. Available at: www.nhlbi.nih.gov/health-topics/coronary-heart-disease (accessed June 2019)
  6. National Health Service. Coronary heart disease. Available at: www.nhs.uk/conditions/coronary-heart-disease/ (accessed June 2019)
  7. Fihn SD et al. Circulation 2014; 130: 1749–67.
  8. Hedgire SS et al. Curr Treat Options Cardio Med 2017; 19: 26.
  9. Berman DS et al. J Nucl Cardiol 2009; 16: 45–53.
  10. Camici PG et al. Nat Rev Cardiol 2015; 12: 48–62.
  11. Nagueh SF et al. J Am Soc Echocardiogr 2016; 29: 277–314.
  12. Gimelli A et al. Eur Heart J 2015: 16; 68–73.
  13. Klocke FJ et al. J Am Coll Cardiol 2003; 42: 1318–1333.
  14. Henzlova MJ et al. ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers. www.asnc.org/files/Guidelines%20and%20Quality/ASNC%20SPECT%20ProtocolsTracers%20Guidelines2016.pdf (accessed June 2019).
  15. Tanaka H et al. Medicine (Baltimore) 2017; 96: e9275.
  16. Melikian N et al. JACC Cardiovasc Interv 2010; 3: 307–314.
  17. Pijls NH and Sels JW. J Am Coll Cardiol 2012; 59: 1045–1057.
  18. van Nunen LX et al. Lancet 2015; 386: 1853–1860.
  19. Pijls NH and van Nunen LX. Cardiovasc Revasc Med 2015; 16: 263–265.
  20. Pijls NH and Dr Bruyne B. Br Med J 1998; 80: 539–542.
  21. Tonino PAL et al. N Engl J Med 2009; 360: 213–224.
  22. Lotfi A et al. Catheter Cardiovasc Interv 2014; 83: 509–518.
  23. Mangiacapra F et al. Expert Rev Cardiovasc Ther 2018; 16: 465–477.
  24. McGeoch RJ and Oldroyd KG. Catheter Cardiovasc Interv 2008; 71: 198–204.
  25. GE Healthcare. Rapiscan Summary of Product Characteristics, 2019.
  26. Gao Z, et al. J Pharmacol Exp Ther 2001;298(1):209–218.
  27. PubChem. Adenosine compound summary. Available at: https://pubchem.ncbi.nlm.nih.gov/compound/Adenosine (accessed July 2019).
  28. PubChem. Regadenoson compound summary. Available at: https://pubchem.ncbi.nlm.nih.gov/compound/Regadenoson (accessed July 2019).
  29. Borea PA, et al. Physiol Rev 2018;98(3):1591–1625.
  30. Thomas GS, et al. J Nucl Cardiol 2008;15(3):319–328
  31. Prenner BM, et al. J Nucl Cardiol 2012;19(4):681–692.
  32. Wu L, et al. Am J Physiol Heart Circ Physiol 2001;280(1):H334–H343.
  33. Lieu HD, et al. J Nucl Cardiol 2007;14(4):514-520.
  34. Belardinelli L, et al. J Pharmacol Exp Ther 1998;284(3):1066–1073. 
  35. Polosa R. Eur Respir J 2002;20(2):488–496.
  36. Gordi T, et al. Clin Pharmacokinet 2006;45(12):1201–1212.
  37. Cerqueira M, et al. JACC Cardiovasc Imaging 2008;1(3):307–316.
  38. Iskandrian AE, et al. J Nucl Cardiol 2007;14(5):645–658.
  39. Cerqueira MD, et al. JACC Cardiovasc Imaging 2008;1(3):307–316
  40. Iskandrian AE, et al. J Nucl Cardiol 2007;14(5):645–658.
  41. GE Healthcare. Rapiscan Summary of Product Characteristics. Available at: www.ema.europa.eu/en/documents/product-information/Rapiscan®-epar-product-information_en.pdf (accessed July 2019).
  42. Mahmarian JJ, et al. JACC Cardiovasc Imaging 2009;2(8):959-968.
  43. Zoghbi G & Iskandrian AE. Imaging Med 2010;2(4):395–406.
  44. van Nunen LX, et al. EuroIntervention 2015;11(8):905–913.
  45. Stolker JM, et al. Cardiovasc Revasc Med 2015;16(5):266–271.
  46. Arumugham P, et al. EuroIntervention 2013;8(10):1166–1171.
  47. Nair PK, et al. JACC Cardiovasc Interv 2011;4(10):1085–1092.
  48. Prasad A, et al. Catheter Cardiovasc Interv 2012;79:S44–S45.
  49. Lieu HD, et al. J Nucl Cardiol 2007;14(4):514-520.
  50. Hendel RC, et al. Am Coll Cardiol 2005;46(11):2069-2075.
  51. GE Healthcare. Rapiscan Summary of Product Characteristics. Available at: www.ema.europa.eu/en/documents/product-information/Rapiscan®-epar-product-information_en.pdf (accessed 2019.
  52. GE Healthcare. Rapiscan Summary of Product Characteristics, . Available at: www.ema.europa.eu/en/documents/product-information/Rapiscan®-epar-product-information_en.pdf (accessed July 2019).
  53. Iskandrian AE, et al. J Nucl Cardiol 2007;14(5):645-658.
  54. van Nunen LX, et al. EuroIntervention 2015(8);11:905–913.
  55. Prenner BM, et al. J Nucl Cardiol 2012;19(4):681-692.
  56. Ananthasubramaniam K, et al. J Nucl Cardiol 2012;19(2):319-329.
  57. GE Healthcare. Rapiscan Summary of Product Characteristics, 2019. Available at: www.ema.europa.eu/en/documents/product-information/Rapiscan®-epar-product-information_en.pdf (accessed July 2019).
  58. Achenbach S, et al. Interv Cardiol 2017;12(2):97–109.
  59. Gori T & Fineschi M. Atlas of FFR-Guided Percutaneous Coronary Interventions, 2016; Springer International Publishing.
  60. Rapiscan (regadenoson) Summary of Product Characteristics (EN), 2019
  61. Cerqueira MD, et al. JACC Cardiovasc Imaging. 2008;1:307–316.
  62. Iskandrian AE, et al. J Nucl Cardiol. 2007;14:645–658
  63. van Nunen LX et al. EuroIntervention 2015;11:905–913
  64. Stolker JM et al. Cardiovasc Revasc Med 2015; 16: 266–271
  65. Arumugham P et al. EuroIntervention 2013; 8: 1166–1171
  66. Nair PK et al. JACC Cardiovasc Interv 2011; 4: 1085–1092
  67. Prasad A et al. Catheter Cardiovasc Interv 2012; 79: S44–S45
     



JB01480UK