Prior COVID-19 should not impact pharmacological MPI stress testing
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Key takeaways:
- Pharmacological stress agents are safe for people who had COVID-19.
- Prior COVID-19 was associated with slightly higher reversal agent use, all-cause costs and office visits.
Prior COVID‐19 was not associated with a higher risk for complications during and after pharmacologic myocardial perfusion imaging stress testing, data from a large claims database analysis show.
“Depending on the local setting, COVID‐19 incidence and availability, the use of pharmacologic myocardial perfusion imaging may be recommended instead of an exercise stress test to reduce droplet exposure risk and, thus, avoid the potential spread of COVID‐19,” David Walker, PhD, director of health economics and clinical outcomes research at Astellas Pharma, and colleagues wrote in Clinical Cardiology. “Although lab closures in response to local and national recommendations early in the pandemic resulted in reduced cardiac diagnostic testing procedures, volumes of procedures in the United States and Canada in 2021 slightly surpassed pre-pandemic levels. However, it remains unknown whether a prior COVID‐19 infection impacts the safety of pharmacologic myocardial perfusion imaging.”
Image: Adobe Stock
In a retrospective study, Walker and colleagues analyzed data from 179,803 adults from the PharMetrics Plus claims database who underwent pharmacologic myocardial perfusion imaging (MPI) between March 2020 and February 2021. Researchers compared patients with a history of COVID‐19 with propensity‐score matched adults with no COVID‐19 history and assessed reversal agent use, 30‐day resource use and post‐MPI cardiac events/procedures.
Within the cohort, 3.5% had prior COVID-19. The most commonly used stress agent was regadenoson (91.7%). Researchers found that, compared with patients without prior infection, those with prior COVID-19 had slightly higher reversal agent use (difference, 1.13%; 95% CI, 0.33-1.92), as well as slightly higher all‐cause costs (difference, $128; 95% CI, 73-181), and more office visits (81.5% vs. 77%) than the no‐COVID‐19 group. Prior COVID‐19 did not appear to impact subsequent cardiac events or procedures.
“The results of this study could help alleviate concerns regarding the safety of pharmacological stress agents in patients with a history of COVID‐19 infection,” the researchers wrote. “However, there remains a need for additional studies to better understand the effect of a prior COVID‐19 infection on the performance and results of exercise or pharmacologic stress testing.”
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