Regadenoson Stress Testing: A Comprehensive Review With a Focused Update

Regadenoson is a pharmacological stress agent that has been widely used since its approval by the Food and Drug Administration (FDA) in 2008. For many years, dipyridamole and adenosine, which are non-selective adenosine receptor agonists, were more popular. However, these agents are less preferred now due to their undesirable adverse effects as compared to regadenoson. In the ADVANCE (ADenoscan Versus regAdenosoN Comparative Evaluation) phase 3 clinical trial, regadenoson demonstrated non-inferiority to adenosine for detecting reversible myocardial ischemia. This review summarizes the clinical utilities of regadenoson as the most widely used pharmacological stress agent. Moreover, the use of regadenoson has been documented in specific patient populations. Although regadenoson has established safety and efficacy in most patients with chronic diseases, there are equivocal results in the literature for other chronic diseases. It is warranted to highlight that the use of regadenoson has not been studied in patients of low socioeconomic class; it is a condition that carries a significant burden on the cardiovascular system.

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

BACKGROUND

Compared with men, women have poorer lipid control. Although potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated (1) whether satisfaction with lipid control and confidence in ability to improve it vary by gender and (2) whether sociodemographic characteristics modify the association.

MATERIALS AND METHODS

We evaluated baseline survey responses from the Cardiovascular Intervention Improvement Telemedicine Study, including self-rated satisfaction with cholesterol levels and confidence in controlling cholesterol. Participants had poorly controlled hypertension and/or hypercholesterolemia.

RESULTS

A total of 428 veterans (15% women) participated. Compared with men, women had higher low-density lipoprotein values at 141.2 versus 121.7 mg/dL, respectively (p < 0.05), higher health literacy, and were less likely to have someone to help track their medications (all p < 0.05). In an adjusted model, women were less satisfied with their cholesterol levels than men with estimated mean scores of 4.3 versus 5.6 on a 1-10 Likert scale (p < 0.05). There was no significant difference in confidence by gender. Participants with support for tracking medications reported higher confidence levels than those without, estimated mean 7.8 versus 7.2 (p < 0.05).

CONCLUSIONS

Women veterans at high risk for cardiovascular disease were less satisfied with their lipid control than men; however, confidence in ability to improve lipid levels was similar. Veterans without someone to help to track medications were less confident, and women were less likely to have this type of social support. Lack of social support for medication tracking may be a factor in lingering gender-based disparities in hyperlipidemia.