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J Invasive Cardiol. 2014 Nov;26(11):580-5.

Effect of caffeine on intravenous adenosine-induced hyperemia in fractional flow reserve measurement.

Author information

1
Cardiovascular Center, Rakuwakai Otowa Hospital, Kyoto, 2, Otowachinji-cho, Yamashina-ku, Kyoto, 607-8062, Japan. matsumoto.hidenari@gmail.com.

Abstract

BACKGROUND:

The interaction between caffeine and adenosine is still a matter of debate.

AIMS:

We examined whether caffeine attenuated intravenous adenosine-induced hyperemia in the measurement of fractional flow reserve (FFR) and whether an increased dose of adenosine overcame the caffeine antagonism.

METHODS:

FFR was measured using different adenosine doses (140, 175, and 210 μg/kg/min) and papaverine as a reference standard in patients with intermediate coronary stenoses, who refrained from caffeine for >24 h (no-caffeine group; n = 14) and those who consumed caffeine (caffeine group; n = 28).

RESULTS:

The median caffeine level in the caffeine group was 2.9 mg/L (interquartile range, 1.8-4.6 mg/L). In the no-caffeine group, FFR with adenosine did not decrease above the dose of 140 μg/kg/min (0.769, 0.771, and 0.770 at 140, 175, and 210 μg/kg/min, respectively) and was not significantly different from that with papaverine (0.765). In the caffeine group, adenosine overestimated FFR (140 μg/kg/min: 0.813, P<.001; 175 μg/kg/min: 0.806, P<.01; 210 μg/kg/min: 0.794, P=.01) compared with papaverine (0.779). The difference in FFR between papaverine and 140 μg/kg/min dose of adenosine was significantly greater in the caffeine group than in the no-caffeine group (0.034 vs 0.004; P<.05).

CONCLUSION:

Caffeine attenuates intravenous adenosine-induced hyperemia in FFR measurement. Even increased adenosine doses up to 210 μg/kg/min cannot fully surmount the antagonism.

PMID:
25363999
[Indexed for MEDLINE]
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