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Effect of caffeine on adenosine-induced reversible perfusion defects assessed by automated analysis

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Journal of Nuclear Cardiology Aims and scope



This prospective study investigated the effects of caffeine ingestion on the extent of adenosine-induced perfusion abnormalities during myocardial perfusion imaging (MPI).


Thirty patients with inducible perfusion abnormalities on standard (caffeine-abstinent) 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.


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).


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.

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The authors are grateful for the assistance of the following colleagues: Dr Scarlett Lewitschnig, Dr Reza Garzan and Philip Stuart RN (Department of Nuclear Medicine), Dr Mark Whitby (Biomedical Technology Services) and Dr Anita Green and Dr Peta Margrie (Cardiology Program).

Conflicts of interest

The authors have indicated that they have no financial conflicts of interest.

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Correspondence to Joseph C. Lee MBBS, FRACP.

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Grants/funding: The Prince Charles Hospital Private Practice Trust Fund.

See related Editorial in this issue by Drs. Hage and Iskandrian. Readers online can view the Editorial at doi:10.1007/s12350-012-9519-8.

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Lee, J.C., Fraser, J.F., Barnett, A.G. et al. Effect of caffeine on adenosine-induced reversible perfusion defects assessed by automated analysis. J. Nucl. Cardiol. 19, 474–481 (2012).

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