Image agreements


The ADVANCE MPI 1 and ADVANCE MPI 2 studies, individually and combined, demonstrated that Rapiscan is similar to adenosine in assessing the extent of reversible perfusion abnormalities (see table) 1,2

 

ADVANCE
MPI 1
(n = 1,113)

ADVANCE
MPI 2
(n = 758)

Combined
Studies
(n = 1,871)

Adenosine – Adenosine Agreement Rate
(± SE) Number of Patients (n)

61 ± 3%
372

64 ± 4%
259

62 ± 3%
631

Adenosine – Rapiscan
Agreement Rate
(± SE) Number of Patients (n)

62 ± 2%
741

63 ± 3%
499

63 ± 2%
1,240

Rate Difference
(Rapiscan – Adenosine)
(± SE) 95% Confidence Interval

1 ± 4%
-7.5, 9.2%

-1 ± 5%
-11.2, 8.7%

0 ± 3%
-6.2, 6.8%

ADVANCE MPI 1 and ADVANCE MPI 2 studies

Methods:

Comparison of the images obtained with Rapiscan or adenosine to those obtained with the baseline adenosine was performed using the 17-segment model.  The number of segments showing a reversible perfusion defect was calculated and categorized as no or low, moderate, or severe perfusion defect for the initial adenosine study and for the randomised study obtained using Rapiscan or adenosine. In the pooled study population, 68% of patients had 0-1 segments showing (no or low) reversible defects on the initial scan, 24% had 2-4 segments (moderate), and 9% had ≥ 5 segments (severe).

The agreement rate for the image obtained with Rapiscan or adenosine relative to the initial adenosine image was calculated by determining how frequently the patients assigned to each initial adenosine category (0-1, 2-4, 5-17 reversible segments) were placed in the same category with the randomised scan. The agreement rates for Rapiscan and adenosine were calculated as the average of the agreement rates across the three categories determined by the initial scan.

References

  1. Rapiscan Summary of Product Characteristics (Download)
  2. Cerqueira MD, Nguyen P, Staehr P, et al, on behalf of the ADVANCE MPI Trial Investigators. Effects of age, gender, obesity and diabetes on the efficacy and safety of the selective A2A agonist Rapiscan versus adenosine: integrated ADVANCE MPI trial results. J Am Coll Cardiol 2008;1:307-316