Safety of dipyridamole testing in 73,806 patients: The Multicenter Dipyridamole Safety Study

Abstract

The risk of serious dipyridamole-induced side effects is very low and is comparable to that reported for exercise testing in a similar patient population.

Direct or indirect stimulation of adenosine A 2A receptors enhances bone regeneration as well as bone morphogenetic protein‐2

“…The topical application of adenosine receptor agonists or agents that increase endogenous adenosine levels has the advantage that the effects of the agents are concentrated locally and that fewer systemic toxicities develop because little of the agent is released systemically. Moreover, dipyridamole has been used systemically (both orally and intravascularly in patients) for decades with little systemic toxicity; the occurrence of severe drug-related adverse effects, including cardiac death, sustained ventricular arrhythmia, cerebral ischemic attack, stroke, or severe bronchospasm, is ,0.02% of patients taking systemic doses of the agent (53,54).…”

Arrhythmias in vasodilator stress testing

“…9 Large-scale studies have also shown that the risk of serious side effects from dipyridamole is low and comparable to those reported in the exercise population. 8 While there have been large studies involving greater than 70,000 patients looking at the safety of dipyridamole, Massalha et al further document the safety of dipyridamole use with a low 0.8% incidence of AV block in 2010 consecutive patients in this issue. Similar to studies with adenosine there were particular at-risk populations worth noting, those with pre-existing AV block.…”

“…7 This method was generally considered safe and low risk to patients. 8 Adenosine stress testing followed suit soon after. 9 Although these were considered safe, the possibility of bronchospasm induced from such non-selective adenosine receptor agonists leads to the development of A2A receptor specific agonists, such as regadenoson in the late 1990s.…”

Safety of stress testing in patients with elevated cardiac biomarkers: Are all modalities created equal?

“…[1][2][3] This supposition has been a solid foundation in our practice such that we often resort to exercise and pharmacologic stress studies as the preferred risk stratification tools and as means to mitigate risk associated with invasive procedures. Before invasive coronary angiography was widely implemented in the evaluation of patients recovering from uncomplicated myocardial infarction (MI), pre-discharge lowlevel exercise stress test, using the modified Bruce protocol, was established as a safe and effective risk stratification tool.…”