Zhongguo quanke yixue (Jun 2024)
Analysis of Adverse Reactions in the Assessment of Coronary Microvascular Disease by Adenosine Load and Adenosine Disodium Triphosphate Load
Abstract
Background The treatment of coronary microvascular disease (CMVD) has always been the focus of non-coronary obstructive ischemic heart disease. Adenosine injection and adenosine disodium triphosphate (ATP) injection, which are common clinical loading drugs to determine coronary flow reserve (CFR) and evaluate CMVD, are related but significantly different. ATP is the precursor of adenosine, with low price and similar vasodilatory mechanism to adenosine, and is often substituted for adenosine in clinical practice, but its potential adverse effects are ignored. Objective To compare the incidence of adverse reactions in the assessment of coronary microvascular disease by adenosine load and adenosine disodium triphosphate load. Methods A total of 170 patients who visited the Department of Cardiology of Shaanxi Provincial People's Hospital for typical angina pectoris and underwent coronarography/Coronary CT angiography (CTA) to determine the residual stenosis diameter of each branch coronary artery <50% during June 2019 to July 2020 were selected and divided into the adenosine group (n=88) and ATP group (n=82) based on random number table method. CFR was determined by adenosine injection loading in the adenosine group and by ATP loading in the ATP group. Blood pressure, heart rate, scanning time and adverse reactions of patients were recorded during the detection process. Results The incidence of adverse reactions of chest tightness [61.0% (50/82) vs 20.4% (18/88) ], dizziness [72.0% (59/82) vs 31.8% (28/88) ], headache [68.3% (56/82) vs 11.4% (10/88) ], gastrointestinal discomfort [13.4% (11/82) vs 4.5% (4/88) ], palpitation [69.5% (57/82) vs 5.7% (5/88) ], shortness of breath [40.2% (33/82) vs 2.3% (2/88) ], profuse sweating [28.0% (23/82) vs 3.4% (3/88) ], hot flush [19.5% (16/82) vs 2.3% (2/88) ] and facial flushing [13.4% (11/82) vs 4.5% (4/88) ] in patients in the ATP group were higher than those in the adenosine group (P<0.05). There was no significant difference in the incidence of neuroticism, tinnitus, dry throat and neck discomfort between the two groups (P>0.05) . Conclusion Compared with ATP loading, adenosine loading has a lower incidence of adverse reactions determine CFR.
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