Effect of caffeine on adenosine-induced  reversible perfusion defects assessed  by automated analysis.
OBJECTIVE
This prospective study investigated the effects of caffeine ingestion on the extent of adenosine-induced perfusion abnormalities during myocardial perfusion imaging (MPI).


METHODS
Thirty patients with inducible perfusion abnormalities on standard (caffeineabstinent) adenosine MPI underwent repeat testing with supplementary coffee intake. Baseline and test MPIs were assessed for stress percent defect, rest percent defect, and percent defect reversibility. Plasma levels of caffeine and metabolites were assessed on both occasions and correlated with MPI findings.


RESULTS
Despite significant increases in caffeine [mean difference 3,106 μg/L (95% CI 2,460 to 3,752 μg/L; P < .001)] and metabolite concentrations over a wide range, there was no statistically significant change in stress percent defect and percent defect reversibility between the baseline and test scans. The increase in caffeine concentration between the baseline and the test phases did not affect percent defect reversibility (average change -0.003 for every 100 μg/L increase; 95% CI -0.17 to 0.16; P = .97).


CONCLUSIONS
There was no significant relationship between the extent of adenosine-induced coronary flow heterogeneity and the serum concentration of caffeine or its principal metabolites. Hence, the stringent requirements for prolonged abstinence from caffeine before adenosine MPI - based on limited studies - appear ill-founded.
Department of Nuclear Medicine, The Prince Charles Hospital, Chermside, QLD 4032, Australia. Joseph_Lee@health.qld.gov.au
Joseph C
JC
Lee
John F
JF
Fraser
Adrian G
AG
Barnett
Leslie P
LP
Johnson
Melinda G
MG
Wilson
Catherine M
CM
McHenry
Darren L
DL
Walters
Christopher R
CR
Warnholtz
Frederick A
FA
Khafagi
D000241:Adenosine / Q000008:administration & dosage; D001783:Blood Flow Velocity / Q000187:drug effects; D002110:Caffeine / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003326:Coronary Circulation / Q000187:drug effects*; D004347:Drug Interactions; D005080:Exercise Test / Q000187:drug effects*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D002110:Caffeine; D000241:Adenosine