title: Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: a prospective, randomized, multicenter study.
abstract: A multicenter, double-blind, randomized study was conducted to assess the effect of caffeine on regadenoson stress myocardial perfusion imaging (MPI). Subjects with a high likelihood of coronary artery disease underwent a rest single-photon emission computed tomography MPI on day 1 (MPI-1) and a stress MPI with regadenoson on day 3 (MPI-2). Individuals with ≥1 segment with a reversible defect received double-blind caffeine tablets (200 or 400 mg) or placebo 90 min before a repeat regadenoson stress MPI (MPI-3) on day 5. Overall, 207 subjects completed the study (caffeine 200 mg, n = 70; caffeine 400 mg, n = 71; placebo, n = 66). The mean number of segments with reversible defects decreased from MPI-2 to MPI-3 in the caffeine 200 and 400 mg groups versus no significant change in the placebo group [mean ± standard deviation: -0.61 ± 1.097, -0.62 ± 1.367, and 0.12 ± 0.981, respectively (overall treatment effect, P < 0.001)]. The majority of subjects who received caffeine shifted to a lower ischemia size category from MPI-2 to MPI-3, with no clear pattern observed in subjects who received placebo. For caffeine exposed patients with ≥3 segments with reversible defects at MPI-2, 21/23 had fewer detected at MPI-3. Both the 200 and 400 mg doses of caffeine significantly reduced the number of segments with reversible defects detected by regadenoson stress MPI.
authors.affiliation: Long Island College Hospital, 339 Hicks Street, Brooklyn, NY, 11201, USA, furqantejanimd@gmail.com.
authors.forename: Furqan H
authors.initials: FH
authors.lastname: Tejani
authors.forename: Randall C
authors.initials: RC
authors.lastname: Thompson
authors.forename: Rita
authors.initials: R
authors.lastname: Kristy
authors.forename: Stan
authors.initials: S
authors.lastname: Bukofzer
mesh_terms: D058908:Adenosine A2 Receptor Agonists; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002110:Caffeine / Q000494:pharmacology*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011687:Purines; D011720:Pyrazoles; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D058908:Adenosine A2 Receptor Agonists; D011687:Purines; D011720:Pyrazoles; C430916:regadenoson; D002110:Caffeine
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