High-dose adenosine overcomes the attenation of myocardial perfusion reserve caused by caffeine

Comment on the above paper

A common problem in patients referred for adenosine stress testing with myocardial perfusion imaging is the use of caffeine in the hours before adenosine is administered.  Reyes et al convincible show that caffeine in coffee indeed attenuates adenosine-induced coronary hyperemia in humans and, consequently, the detection of perfusion abnormalities by adenosine MPS.   However, they also show that this effect can be overcome by increasing the adenosine dose from 140 ug/kg/min to 210 ug/kg/min, without additional clinical side effects.