Regadenoson for myocardial perfusion imaging: Is it safe?

Regadenoson is currently the most widely used pharmacologic stress agent for myocardial perfusion imaging (MPI) with millions of doses administered annually in the US. In November 2013, the US Food and Drug Administration (FDA) issued a Drug Safety Communication warning health care professionals of the rare but serious risk of heart attack and death with use of either regadenoson or adenosine. In this issue of the Journal, Rosenblatt et al report on 2 cases of asystole following regadenoson administration for MPI in stable outpatients. These reports raise legitimate concerns with regard to safety of regadenoson considering its widespread use and the dictum of ‘‘do no harm.’’