Document Detail

Incidence of caffeine in serum of patients undergoing dipyridamole myocardial perfusion stress test by an intensive versus routine caffeine history screening.
MedLine Citation:
PMID:  20451698     Owner:  NLM     Status:  MEDLINE    
The coronary vasodilatory effect of dipyridamole is competitively blocked by caffeine. The purposes of this study were to (1) assess the incidence of having detectable serum caffeine and (2) evaluate whether an intensive caffeine history screening strategy was superior to routine history screening before dipyridamole myocardial perfusion imaging. One hundred ninety-four patients who were randomized to an intensive or a routine screening history strategy were prospectively evaluated. Serum caffeine levels were determined in all patients. Outcomes data, including death, nonfatal myocardial infarction, and history of revascularization, were obtained at 24 months. Nearly 1 in 5 patients (19%) who screened negative by history had detectable serum caffeine. In patients who screened negative by history, there was no statistically significant difference in the percentage of caffeine seropositivity between the intensive and routine arms (16% vs 22%, respectively, p = 0.31). The incidence of combined end points of death, myocardial infarction, or revascularization was 22.9% and 7.3% in patients with and without detectable serum caffeine, respectively (p = 0.01). In conclusion, despite initial negative results on screening by history, a considerably high percentage of patients had positive serum caffeine levels. These results do not support the use of an intensive screening strategy. Detectable serum caffeine was associated with a higher incidence of adverse outcomes.
Lesan T Banko; Salman A Haq; Debroah A Rainaldi; Igor Klem; Jason Siegler; Joshua Fogel; Terrence J Sacchi; John F Heitner
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-04-08
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1474-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
New York Methodist Hospital, Brooklyn, New York, USA.
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MeSH Terms
Caffeine / adverse effects,  blood*,  pharmacology
Coronary Disease / blood,  radionuclide imaging*
Dipyridamole / diagnostic use*,  pharmacology
Drug Interactions
Exercise Test / methods*
Hemodynamics / drug effects
Mass Screening / methods
Medical History Taking / methods
Middle Aged
Multivariate Analysis
Myocardial Infarction / epidemiology,  etiology
Myocardial Perfusion Imaging / methods*
Prospective Studies
Reference Values
Regression Analysis
Risk Factors
Sensitivity and Specificity
Vasodilator Agents / diagnostic use,  pharmacology
Reg. No./Substance:
0/Vasodilator Agents; 58-08-2/Caffeine; 58-32-2/Dipyridamole

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