Caffeine intake inverts the effect of adenosine on myocardial perfusion during stress as measured by T1 mapping
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Key result
Recent caffeine intake blunts adenosine stress CMR, inverting T1 reactivity to -7.8%.
- P<0.0005
- n=105
Why the study?
Caffeine intake before adenosine stress myocardial perfusion imaging may cause false negative findings, and its effect can be measured by T1 mapping techniques.
Does caffeine intake alter T1 reactivity during adenosine stress cardiac magnetic resonance imaging in patients undergoing myocardial perfusion imaging?
Population
105 consecutive patients undergoing adenosine stress perfusion CMR on a 1.5-T MRI system
Comparison
Caffeine intake within 4 hours or >8 hours prior to adenosine stress CMR vs no self-reported coffee intake
Design
Prospective observational study
Authors
Discussion
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Member takes
Implication
Caffeine abstinence remains prudent before adenosine stress CMR; supports T1 mapping for detecting antagonism but leaves clinical utility hypothesis-generating.
Study Design
Type
Observational (n=105)
Blinding
Single-blind
Multicenter
No
Structured PICO
Does caffeine intake alter T1 reactivity during adenosine stress cardiac magnetic resonance imaging in patients undergoing myocardial perfusion imaging?
P
Population
105 patients referred for stress perfusion CMR due to suspected myocardial ischemia, evaluated for the effect of recent caffeine intake on T1 reactivity.
E
Exposure
Caffeine intake (coffee) within 4 hours or >8 hours prior to adenosine stress CMR.
C
Comparator
Patients without self-reported coffee intake (controls with normal CMR, patients with myocardial ischemia, and patients with myocardial infarction).
O
Outcome
T1 reactivity, defined as the difference between rest T1 and adenosine stress T1 (∆T1).surrogate
Main Result
Absolute Event Rate: -7.8% vs 4.3%
p-value: p=<0.0005
Caffeine intake within 4 hours of adenosine stress CMR inverts the adenosine effect as measured by T1 mapping, highlighting the importance of caffeine abstinence and the potential of T1 reactivity to assess stress adequacy.
Limitations
- Categorical information about coffee intake without detailed evaluation of caffeine levels per patient
- MOLLI-based T1 mapping technique revealed a substantial number of motion artefacts
- Small sample size in the caffeine exposure groups
Cite This Study
Kuijpers et al. (2016) conducted an observational in Suspected myocardial ischemia (n=105). Caffeine intake within 4 hours of CMR vs. No self-reported coffee intake (controls with normal CMR) was evaluated on T1 reactivity (∆T1), defined as percentage difference between T1rest and T1stress (p=<0.0005). Caffeine intake within 4 hours of adenosine stress CMR inverted T1 reactivity to -7.8% compared to a 4.3% increase in controls (p < 0.0005), indicating inadequate stress induction.
Topics
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