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Coronary artery disease Definition Coronary artery disease (CAD) is a common disease that causes the restricting of the artery passages that supply blood and oxygen to the heart. An accumulation of plaque in the arteries results in restriction of blood and oxygen to the heart (Discovermi.org - SNM, 2011). In 2009, the National Vital Statistics Reports claimed that diseases of the heart were the top leading cause of death in the United States for both men and women (by Kenneth D. Kochanek, Jiaquan Xu, Sherry L. Murphy, M.P.H., & and Hsiang-Ching Kung, 2011). Role of molecular imaging Myocardial perfusion imaging (MPI) and positron emission tomography (PET) imaging studies help: Diagnose and provide a prognosis of CAD. Evaluate a patient’s response to CAD treatment. Identify patients who may benefit from revascularization, or coronary bypass surgery. (Discovermi.org - SNM, 2011) Radiopharmaceutical Manufacturer Flourine-18 fluorodeoxyglucose Various MPI viability Nitrogen-13 ammonia Various PET agent used for evaluation of myocardial blood flow (perfusion) Rubidim-82 chloride Bracco Diagnostics Technetium-99m sestamibi Cardinal Health Covidien DRAXIMAGE Lantheus Medical Imaging Pharmalucence Technetium-99m tetrofosmin GE Healthcare Thallium-201 chloride Covidien GE Healthcare Lantheus Medical Imaging Trade names ® Cardiogen-82 Approved indications in adults PET myocardial perfusion agent that is useful in distinguishing normal from abnormal myocardium in patients with suspected myocardial infarction ® Myocardial perfusion agent that is indicated for: Detecting coronary artery disease by localizing myocardial ischemia (reversible defects) and infarction (nonreversible defects) Evaluating myocardial function Developing information for use in patient management decisions Myoview™ Myocardial perfusion agent that is indicated for: Detecting coronary artery disease by localizing myocardial ischemia (reversible defects) and infarction (nonreversible defects) The assessment of left ventricular function (left ventricular ejection fraction and wall motion) Cardiolite Useful in myocardial perfusion imaging for the diagnosis and localization of myocardial infarction As an adjunct in the diagnosis of ischemic heart disease (atherosclerotic coronary artery disease) © 2015 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. . Pharmacological stress agents Manufacturer Trade names Adenosine Astellas Adenoscan Regadenoson Astellas Lexiscan Dipyridamole Various ® ® Approved indications in adults Pharmacologic stress agent used in patients with an intermediate-to-high pretest likelihood of CAD who are unable to exercise Pharmacologic stress agent indicated for radionuclide MPI in patients unable to undergo adequate exercise stress IV injection is a coronary vasodilator MSDS and package insert information © 2015 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. .