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

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Objectives

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 (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.

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).

Conclusion

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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Acknowledgments

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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Authors and Affiliations

  1. Department of Nuclear Medicine, The Prince Charles Hospital, Chermside, QLD, 4032, Australia

    Joseph C. Lee MBBS, FRACP, Melinda G. Wilson BAppSc, Catherine M. McHenry BAppSc & Frederick A. Khafagi MBBS, FRACP

  2. Cardiology Program, The Prince Charles Hospital, Chermside, QLD, 4032, Australia

    Joseph C. Lee MBBS, FRACP & Darren L. Walters MBBS, FRACP, MPhil

  3. Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, 4032, Australia

    Joseph C. Lee MBBS, FRACP & John F. Fraser MBChB, MRCP, PhD

  4. School of Medicine, University of Queensland, Herston, QLD, 4006, Australia

    Joseph C. Lee MBBS, FRACP, John F. Fraser MBChB, MRCP, PhD, Darren L. Walters MBBS, FRACP, MPhil & Frederick A. Khafagi MBBS, FRACP

  5. Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia

    John F. Fraser MBChB, MRCP, PhD & Adrian G. Barnett PhD

  6. Department of Chemical Pathology, Pathology Queensland, Royal Brisbane and Women’s Hospital, Herston, QLD, 4029, Australia

    Leslie P. Johnson PhD & Christopher R. Warnholtz BAppSc

Authors
  1. Joseph C. Lee MBBS, FRACP
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  2. John F. Fraser MBChB, MRCP, PhD
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  9. Frederick A. Khafagi MBBS, FRACP
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Corresponding author

Correspondence to Joseph C. Lee MBBS, FRACP.

Additional information

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). https://doi.org/10.1007/s12350-012-9517-x

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  • DOI: https://doi.org/10.1007/s12350-012-9517-x

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