Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: Rationale and design of a prospective, randomized, multicenter study

Tejani, Furqan H.; Thompson, Randall C.; Iskandrian, Ami E.; McNutt, Bruce E.; Franks, Billy

doi:10.1007/s12350-010-9311-6

Cited by 16 publications

(5 citation statements)

References 42 publications

(38 reference statements)

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“…The subjects were also regular caffeine consumers (≥1 cup of caffeinated coffee per day or equivalent). Key inclusion and exclusion criteria have been detailed previously [10]. …”

Section: Methodsmentioning

confidence: 99%

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Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: a prospective, randomized, multicenter study

Tejani¹,

Thompson

Kristy

et al. 2014

Int J Cardiovasc Imaging

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A multicenter, double-blind, randomized study was conducted to assess the effect of caffeine on regadenoson stress myocardial perfusion imaging (MPI). Subjects with a high likelihood of coronary artery disease underwent a rest single-photon emission computed tomography MPI on day 1 (MPI-1) and a stress MPI with regadenoson on day 3 (MPI-2). Individuals with ≥1 segment with a reversible defect received double-blind caffeine tablets (200 or 400 mg) or placebo 90 min before a repeat regadenoson stress MPI (MPI-3) on day 5. Overall, 207 subjects completed the study (caffeine 200 mg, n = 70; caffeine 400 mg, n = 71; placebo, n = 66). The mean number of segments with reversible defects decreased from MPI-2 to MPI-3 in the caffeine 200 and 400 mg groups versus no significant change in the placebo group [mean ± standard deviation: −0.61 ± 1.097, −0.62 ± 1.367, and 0.12 ± 0.981, respectively (overall treatment effect, P < 0.001)]. The majority of subjects who received caffeine shifted to a lower ischemia size category from MPI-2 to MPI-3, with no clear pattern observed in subjects who received placebo. For caffeine exposed patients with ≥3 segments with reversible defects at MPI-2, 21/23 had fewer detected at MPI-3. Both the 200 and 400 mg doses of caffeine significantly reduced the number of segments with reversible defects detected by regadenoson stress MPI.

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“…The subjects were also regular caffeine consumers (≥1 cup of caffeinated coffee per day or equivalent). Key inclusion and exclusion criteria have been detailed previously [10]. …”

Section: Methodsmentioning

confidence: 99%

“…The safety and tolerability of concomitant caffeine and regadenoson administration were also assessed. A detailed discussion of the rationale and description of the study design has been published previously [10]. …”

Section: Introductionmentioning

confidence: 99%

Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: a prospective, randomized, multicenter study

Tejani¹,

Thompson

Kristy

et al. 2014

Int J Cardiovasc Imaging

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“…Therefore, pharmacokinetic and pharmacodynamic (PK/PD) interactions between caffeine and adenosine receptor ligands may contribute to the varying responses to an adenosine receptor-based drug in clinical trials (BOX 2). Indeed, PK/PD analyses show that recent caffeine ingestion (equivalent to two to four cups of coffee) affects A 2A receptor agonist-induced myocardial perfusion imaging 229 and reduces the efficacy of adenosine in the treatment of paroxysmal supraventricular tachycardia 230 . In this regard, it is somewhat surprising that several current clinical trials of adenosine receptor antagonists have not taken caffeine consumption into consideration in their clinical trial designs.…”

Section: Overview Of Adenosine Receptorsmentioning

confidence: 99%

Adenosine receptors as drug targets — what are the challenges?

Chen

Eltzschig

Fredholm

2013

Nat Rev Drug Discov

765

888

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Adenosine signalling has long been a target for drug development, with adenosine itself or its derivatives being used clinically since the 1940s. In addition, methylxanthines such as caffeine have profound biological effects as antagonists at adenosine receptors. Moreover, drugs such as dipyridamole and methotrexate act by enhancing the activation of adenosine receptors. There is strong evidence that adenosine has a functional role in many diseases, and several pharmacological compounds specifically targeting individual adenosine receptors — either directly or indirectly — have now entered the clinic. However, only one adenosine receptor-specific agent — the adenosine A2A receptor agonist regadenoson (Lexiscan; Astellas Pharma) — has so far gained approval from the US Food and Drug Administration (FDA). Here, we focus on the biology of adenosine signalling to identify hurdles in the development of additional pharmacological compounds targeting adenosine receptors and discuss strategies to overcome these challenges.

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“…Furthermore, a recent study suggests that moderate caffeine consumption may not significantly affect regadenoson-induced coronary vasodilation in healthy individuals, and may actually improve tolerability of regadenoson stress testing [49]. A larger study examining the interaction of regadenoson and caffeine is currently in progress [50]. There are no published data yet available on the effect of caffeine consumption on binodenoson or apadenoson.…”

Section: Interaction With Caffeinementioning

confidence: 99%

Pharmacologic Stress Using Selective A2A Adenosine Receptor Agonists

Hendel

Moreno

Glover

2011

Curr Cardiovasc Imaging Rep

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Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: Rationale and design of a prospective, randomized, multicenter study

Abstract: The results of this study will show whether the consumption of caffeine equivalent to 2-4 cups of coffee prior to an MPI study with regadenoson affects the diagnostic validity of stress testing (ClinicalTrials.gov number, NCT00826280).

Cited by 16 publications

References 42 publications

Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: a prospective, randomized, multicenter study

Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: a prospective, randomized, multicenter study

Adenosine receptors as drug targets — what are the challenges?

Pharmacologic Stress Using Selective A2A Adenosine Receptor Agonists

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