{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:16:37Z","timestamp":1788869797471,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T00:00:00Z","timestamp":1534118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background. Caffeine is one of the most widely consumed stimulants worldwide. It is a well-recognized antagonist of adenosine and a potential cause of false-negative functional measurements during vasodilator myocardial perfusion. The aim of this systematic review is to summarize the evidence regarding the effects of caffeine intake on functional measurements of myocardial perfusion in patients with suspected coronary artery disease. Pubmed, Web of Science, and Embase were searched using a predefined electronic search strategy. Participants\u2014healthy subjects or patients with known or suspected CAD. Comparisons\u2014recent caffeine intake versus no caffeine intake. Outcomes\u2014measurements of functional myocardial perfusion. Study design\u2014observational. Fourteen studies were deemed eligible for this systematic review. There was a wide range of variability in study design with varying imaging modalities, vasodilator agents, serum concentrations of caffeine, and primary outcome measurements. The available data indicate a significant influence of recent caffeine intake on cardiac perfusion measurements during adenosine and dipyridamole induced hyperemia. These effects have the potential to affect the clinical decision making by re-classification to different risk-categories.<\/jats:p>","DOI":"10.3390\/nu10081083","type":"journal-article","created":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T11:27:13Z","timestamp":1534159633000},"page":"1083","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Effects of Caffeine on Myocardial Blood Flow: A Systematic Review"],"prefix":"10.3390","volume":"10","author":[{"given":"Randy","family":"Van Dijk","sequence":"first","affiliation":[{"name":"Center for Medical Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Department of Cardiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6472-9886","authenticated-orcid":false,"given":"Daan","family":"Ties","sequence":"additional","affiliation":[{"name":"Center for Medical Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Department of Cardiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8373-1172","authenticated-orcid":false,"given":"Dirkjan","family":"Kuijpers","sequence":"additional","affiliation":[{"name":"Center for Medical Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"HMC-Bronovo, Haaglanden Medisch Centrum, Department of Radiology, Haaglanden Medisch Centrum-Bronovo, 2597 AX The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"Van der Harst","sequence":"additional","affiliation":[{"name":"Center for Medical Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Department of Cardiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Oudkerk","sequence":"additional","affiliation":[{"name":"Center for Medical Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.2147\/VHRM.S1798","article-title":"Regadenoson in the detection of coronary artery disease","volume":"4","author":"Buhr","year":"2008","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ejphar.2005.12.056","article-title":"Adenosine in the airways: Implications and applications","volume":"533","author":"Spicuzza","year":"2005","journal-title":"Eur. J. Pharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S0165-6147(03)00193-7","article-title":"Research applications and implications of adenosine in diseased airways","volume":"24","author":"Spicuzza","year":"2003","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"33D","DOI":"10.1016\/j.amjcard.2004.04.017","article-title":"The future of pharmacologic stress: Selective A2A adenosine receptor agonists","volume":"94","author":"Cerqueira","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1161\/01.CIR.98.7.711","article-title":"A2A-Adenosine receptor reserve for coronary vasodilation","volume":"98","author":"Shryock","year":"1998","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.jacc.2009.04.089","article-title":"Regadenoson: A new myocardial stress agent","volume":"54","author":"Jaroudi","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1016\/j.jacc.2005.05.097","article-title":"Initial clinical experience with regadenoson, a novel selective A2A Agonist for pharmacologic stress single-photon emission computed tomography myocardial perfusion imaging","volume":"46","author":"Hendel","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.nuclcard.2008.02.013","article-title":"Safety of regadenoson, a selective adenosine A2A agonist, in patients with chronic obstructive pulmonary disease: A randomized, double-blind, placebo-controlled trial (RegCOPD trial)","volume":"15","author":"Thomas","year":"2008","journal-title":"J. Nucl. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1600-0773.1995.tb00111.x","article-title":"Adenosine, adenosine receptors and the actions of caffeine","volume":"76","author":"Fredholm","year":"1995","journal-title":"Pharmacol. Toxicol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1002\/jmri.25032","article-title":"Factors associated with false-negative cardiovascular magnetic resonance perfusion studies: A clinical evaluation of magnetic resonance imaging in coronary artery disease (CE-MARC) substudy","volume":"43","author":"Kidambi","year":"2016","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s12350-015-0371-5","article-title":"Caffeine reduces the sensitivity of vasodilator MPI for the detection of myoardial ischaemia: Pro","volume":"23","author":"Reyes","year":"2016","journal-title":"J. Nucl. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1007\/s12350-015-0364-4","article-title":"Caffeine does not significantly reduce the sensitivity of vasodilator stress myocardial perfusion imaging","volume":"23","author":"Saab","year":"2015","journal-title":"J. Nucl. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.nuclcard.2004.04.003","article-title":"The impact of caffeine on vasodilator stress perfusion studies","volume":"11","author":"Lapeyre","year":"2004","journal-title":"J. Nucl. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (EFSA) (2015). Scientific opinion on the safety of caffeine1 EFSA panel on dietetic products, nutrition and allergies (NDA). ESFA J., 13, 4102.","DOI":"10.2903\/j.efsa.2015.4148"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1093\/jat\/27.7.520","article-title":"Caffeine content of specialty coffees","volume":"27","author":"McCusker","year":"2003","journal-title":"J. Anal. Toxicol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.amjcard.2009.12.072","article-title":"Incidence of caffeine in serum of patients undergoing dipyridamole myocardial perfusion stress test by an intensive versus routine caffeine history screening","volume":"105","author":"Banko","year":"2009","journal-title":"Am. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/cpf.12125","article-title":"Submaximal adenosine-induced coronary hyperaemia with 12 h caffeine abstinence: Implications for clinical adenosine perfusion imaging tests","volume":"35","author":"Carlsson","year":"2015","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1093\/eurheartj\/ehu278","article-title":"2014 ESC\/EACTS Guidelines onmyocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"35","author":"Windecker","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e002666","DOI":"10.1161\/CIRCIMAGING.114.002666","article-title":"Diagnostic accuracy of stress myocardial perfusion imaging compared to invasive coronary angiography with fractional flow reserve meta-analysis","volume":"8","author":"Takx","year":"2015","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1007\/s12350-012-9517-x","article-title":"Effect of caffeine on adenosine-induced reversible perfusion defects assessed by automated analysis","volume":"19","author":"Lee","year":"2012","journal-title":"J. Nucl. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1016\/j.jacc.2005.11.088","article-title":"Effect of caffeine on ischemia detection by adenosine single-photon emission computed tomography perfusion imaging","volume":"47","author":"Zoghbi","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1016\/j.jacc.2008.08.052","article-title":"High-dose adenosine overcomes the attenuation of myocardial perfusion reserve caused by caffeine","volume":"52","author":"Reyes","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","first-page":"1538","article-title":"False-negative dipyridamole-thallium-201 myocardial imaging after caffeine infusion","volume":"32","author":"Smits","year":"1991","journal-title":"J. Nucl. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1007\/s10554-014-0419-7","article-title":"Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: A prospective, randomized, multicenter study","volume":"30","author":"Tejani","year":"2014","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_25","first-page":"2016","article-title":"Effect of caffeine on myocardial blood flow at rest and during pharmacological vasodilation","volume":"36","author":"Czernin","year":"1995","journal-title":"J. Nucl. Med."},{"key":"ref_26","first-page":"730","article-title":"Effect of caffeine intake on myocardial hyperemic flow induced by adenosine triphosphate and dipyridamole","volume":"45","author":"Kubo","year":"2004","journal-title":"J. Nucl. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s12968-017-0412-0","article-title":"Effects of caffeine on the detection of ischemia in patients undergoing adenosine stress cardiovascular magnetic resonance imaging","volume":"19","author":"Greulich","year":"2017","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1007\/s10554-017-1157-4","article-title":"Effects of caffeine intake prior to stress cardiac magnetic resonance perfusion imaging on regadenoson-versus adenosine-induced hyperemia as measured by T1 mapping","volume":"33","author":"Kuijpers","year":"2017","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1007\/s12928-017-0456-y","article-title":"Effects of caffeine on fractional flow reserve values measured using intravenous adenosine triphosphate","volume":"33","author":"Nakayama","year":"2018","journal-title":"Cardiovasc. Interv. Ther."},{"key":"ref_30","first-page":"580","article-title":"Effect of caffeine on intravenous adenosine-induced hyperemia in fractional flow reserve measurement","volume":"26","author":"Matsumoto","year":"2014","journal-title":"J. Invasive Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e000060","DOI":"10.1136\/openhrt-2014-000060","article-title":"Effects of intravenous caffeine on fractional flow reserve measurements in coronary artery disease","volume":"1","author":"Mutha","year":"2014","journal-title":"Open Heart"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.amjcard.2003.10.017","article-title":"Effect of caffeine administered intravenously on intracoronary-administered adenosine-induced coronary hemodynamics in patients with coronary artery disease","volume":"93","author":"Aqel","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2949","DOI":"10.1093\/eurheartj\/eht296","article-title":"2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology","volume":"34","author":"Montalescot","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1161\/01.CIR.97.6.535","article-title":"Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: Differential stratification for risk of cardiac death and myocardial infarction","volume":"97","author":"Hachamovitch","year":"1998","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s10554-016-0974-1","article-title":"Hold off on that shot of Java: More evidence that caffeine intake leads to false negative adenosine stress myocardial perfusion","volume":"33","author":"Leiner","year":"2017","journal-title":"Int. J. Cardiovasc. 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