Effects of caffeine on fractional flow reserve values measured using intravenous adenosine triphosphate
We investigated the effects of caffeine intake on fractional flow reserve (FFR) values measured using intravenous adenosine triphosphate (ATP) before cardiac catheterization. Caffeine is a competitive antagonist for adenosine receptors; however, it is unclear whether this antagonism affects FFR values. Patients were evenly randomized into 2 groups preceding the FFR study. In the caffeine group (n = 15), participants were given coffee containing 222 mg of caffeine 2 h before the catheterization. In the non-caffeine group (n = 15), participants were instructed not to take any caffeine-containing drinks or foods for at least 12 h before the catheterization. FFR was performed in patients with more than intermediate coronary stenosis using the intravenous infusion of ATP at 140 μg/kg/min (normal dose) and 170 μg/kg/min (high dose), and the intracoronary infusion of papaverine. FFR was followed for 30 s after maximal hyperemia. In the non-caffeine group, the FFR values measured with ATP infusion were not significantly different from those measured with papaverine infusion. However, in the caffeine group, the FFR values were significantly higher after ATP infusion than after papaverine infusion (P = 0.002 and P = 0.007, at normal and high dose ATP vs. papaverine, respectively). FFR values with ATP infusion were significantly increased 30 s after maximal hyperemia (P = 0.001 and P < 0.001 for normal and high dose ATP, respectively). The stability of the FFR values using papaverine showed no significant difference between the 2 groups. Caffeine intake before the FFR study affected FFR values and their stability. These effects could not be reversed by an increased ATP dose.
KeywordsFractional flow reserve Caffeine Adenosine triphosphate Coronary artery disease Coronary circulation
We thank Dr. Eisei Oda of Medical TOUKEI Corporation, Tokyo, Japan, for support with the statistical analysis. We also thank Dr. Edward F. Barroga, Associate Professor and Senior Medical Editor of the Department of International Communications at Tokyo Medical University for reviewing and editing the manuscript.
Compliance with ethical standards
Conflict of interest
This study was funded by Volcano Corporation (San Diego, CA, USA). The sponsor had no control over the interpretation, writing, or publication of this work. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Human rights and ethical standards
The study protocol was approved by the ethics committee of Toda Central General Hospital, and the study was performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients prior to their enrollment in this study.
- 6.Tarkin JM, Nijjer S, Sen S, Petraco R, Echavarria-Pinto M, Asress KN, et al. Hemodynamic response to intravenous adenosine and its effect on fractional flow reserve assessment: results of the Adenosine for the Functional Evaluation of Coronary Stenosis Severity (AFFECTS) study. Circ Cardiovasc Interv. 2013;6:654–61.CrossRefPubMedGoogle Scholar
- 16.Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.CrossRefPubMedGoogle Scholar
- 17.Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, Dohi S, et al. Cardiovascular disease risk factors other than dyslipidemia. Executive summary of the Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan—2012 version. J Atheroscler Thromb. 2013;20:733–42.CrossRefPubMedGoogle Scholar