The impact of caffeine on vasodilator stress perfusion studies

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

“…31 Patients fast for a minimum of 4 hour, avoid smoking for at least 4 hour, and avoid caffeine intake for at least 12 hour before vasodilator stress. [32][33][34] Vasodilator stress with adenosine, 35 dipyridamole, 36 and regadenoson 37 has been evaluated using 13 N-ammonia, 82 Rb-chloride, and 15 O-water. After excluding contraindications, a stress agent is infused on the basis of standard protocols ( Table 2).…”

Pharmacologic Stress Using Selective A2A Adenosine Receptor Agonists

“…It is generally accepted that caffeine consumption can potentially lower the sensitivity of SPECT in conjunction with adenosine by masking myocardial ischemia and identification of intermediate coronary lesions due to the competitive inhibition of the A 2A adenosine receptor [44,45]. However, in a recent study, one 8-ounce cup of coffee consumed 1 h before adenosine SPECT imaging did not mask the presence or severity of known reversible defects [46].…”

Pitfalls and Limitations of Radionuclide and Hybrid Cardiac Imaging

“…31,32 Reports vary regarding the degree to which caffeine blunts the vasodilatory response to pharmacologic stress agents. 33 Although studies report attenuation of HR and BP response to dipyridamole, 34 antagonism of adenosineinduced human forearm vascular dilatation, 35 and blunting of dipyridamole induced coronary hyperemia, 36 in contrast Aqel et al 37 reported that caffeine does not blunt 13 NH 3 -measured fractional flow reserve after an intracoronary adenosine bolus, Zoghbi et al 38 reported that one eight-oz cup of coffee taken 1 hour before adenosine stress did not affect the presence or severity of reversible perfusion defects, and Gaemperli et al saw no effect of 200-mg caffeine on 15 O-labeled water-measured coronary flow reserve. 39 However, these studies all had small (o50) patient cohorts.…”