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Binodenoson is a highly selective adenosine A2A receptor agonist developed as a pharmacologic stress agent for use in single-photon emission computed tomographic (SPECT) myocardial perfusion imaging. It was intended for patients with or at risk for coronary artery disease (CAD) who are unable to perform exercise-based cardiac stress tests. By selectively activating the adenosine A2A receptor—responsible for coronary vasodilation—binodenoson increases cardiac blood flow with fewer side effects compared to less selective agents like adenosine or dipyridamole. Its selectivity reduces the risk of bronchoconstriction and other adverse reactions associated with non-selective adenosine agonists. The drug was designed to be administered as a single intravenous bolus injection rather than prolonged infusion[1][2][3][4][5]. Despite its potential advantages, binodenoson did not receive FDA approval due to concerns about efficacy equivalence compared to existing agents[1][4].
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