Published online May 26, 2022. doi: 10.4330/wjc.v14.i5.319
Peer-review started: April 13, 2021
First decision: October 17, 2021
Revised: November 21, 2021
Accepted: April 26, 2022
Article in press: April 26, 2022
Published online: May 26, 2022
Processing time: 400 Days and 6.8 Hours
Regadenoson is a selective adenosine receptor agonist that causes coronary hyperemia and in limited studies has been shown to have comparative efficacy to adenosine in evaluating coronary fractional flow reserve (FFR).
Considering the evidence is limited in supporting the use of regadenoson as an alternative to adenosine in evaluating FFR, we hypothesized that using meta-analysis we can improve the strength of evidence comparing regadenoson vs adenosine in evaluating FFR in intermediate severity coronary stenosis.
To perform meta-analysis to evaluate regadenoson vs adenosine for efficacy and safety.
Pooled meta-analysis of published studies. Comparing correlation coefficient and adverse events using random effects model. Visual inspection for bias and heterogeneity assessment using I2 test.
The FFR correlation coefficient between regadenoson and adenosine was 0.98 [95% confidence interval (CI): 0.96-0.99, P < 0.01]. Time to achieve FFR was shorter by 34.31 s (95%CI: 25.14-43.48) in the regadenoson group. The risk of adverse events was higher with adenosine with odds ratio of 2.39 (95%CI: 1.22-4.67, P = 0.01).
Regadenoson had comparable efficacy in obtaining FFR compared to adenosine and this was achieved in a shorter duration of time and with lower incidence of adverse effects.
Regadenoson presents an alternative to adenosine in evaluating FFR in patients with intermediate severity coronary artery stenosis with lower risk of side effects and also saves time.