Practicing safe SPECT: Caffeine abstinence in nuclear myocardial perfusion imaging

Kristina E. Powles BASc, Renee C. Hessian BSc, FRCPC, Terrence D. Ruddy FRCPC, FACCb
Review Articles
Volume 15, Issue 5 / September , 2008

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Conclusions

The studies available, however, do suggest that there should be concerns about patients arriving for nuclear stress testing with high caffeine levels. Because of the interindividual variation in caffeine metabolism and the varied caffeine content of products, health care professionals cannot use “cups of coffee” as a reliable measure of how much caffeine a patient has consumed to predict serum levels.

For now, we believe that nuclear laboratories should have clear instructions to patients about caffeine abstinence and periodic confirmation via random monitoring. Further research should be carried out in this area, with a carefully selected patient population. There is no current evidence that 1 cup of coffee will not alter patient testing and the final diagnosis of coronary disease. Caffeine abstinence for at least 24 hours remains the safest approach for all patients scheduled for nuclear MPI with either dipyridamole or adenosine. It is possible that there is less of an influence of caffeine with adenosine stress and the abstinence period could be reduced to 12 hours.

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