Coffee consumption and adverse cardiovascular events in patients with atrial fibrillation

Vasco Iten; Elena Herber; Michael Coslovsky; Elisa Hennings; Rebecca E Paladini; Tobias Reichlin; Nicolas Rodondi; Andreas S Müller; Annina Stauber; Juerg H Beer; Roman Brenner; Giulio Conte; Richard Kobza; Marcello Di Valentino; Patricia Chocano Bedoya; Freschteh Moradi; Tim Sinnecker; Leo H Bonati; Michael Kühne; Stefan Osswald; David Conen; Stefanie Aeschbacher; Christine S Zuern; Swiss-AF and Beat-AF Investigators

doi:10.1186/s12916-024-03817-x

Coffee consumption and adverse cardiovascular events in patients with atrial fibrillation

BMC Med. 2024 Dec 18;22(1):593. doi: 10.1186/s12916-024-03817-x.

Authors

Vasco Iten^{1

2}, Elena Herber^{1

2}, Michael Coslovsky^{1

2

3}, Elisa Hennings^{1

2}, Rebecca E Paladini^{1

2}, Tobias Reichlin⁴, Nicolas Rodondi^{5

6}, Andreas S Müller⁷, Annina Stauber⁷, Juerg H Beer⁸, Roman Brenner⁹, Giulio Conte¹⁰, Richard Kobza¹¹, Marcello Di Valentino¹², Patricia Chocano Bedoya⁶, Freschteh Moradi^{1

2}, Tim Sinnecker¹³, Leo H Bonati^{14

15}, Michael Kühne^{1

2}, Stefan Osswald^{1

2}, David Conen¹⁶, Stefanie Aeschbacher^#^{17

18}, Christine S Zuern^#^{19

20}; Swiss-AF and Beat-AF Investigators

Affiliations

¹ Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
² Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
³ Department Klinische Forschung, University of Basel and University Hospital, Basel, Switzerland.
⁴ Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁵ Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁶ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
⁷ Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland.
⁸ Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zurich, Zurich, Switzerland.
⁹ Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹⁰ Division of Cardiology, Cardiocentro Ticino Insitute, Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹¹ Department of Cardiology, Kantonsspital Luzern, Luzern, Switzerland.
¹² Department of Cardiology, Ospedale San Giovanni, Bellinzona, Switzerland.
¹³ Department of Biomedical Engineering, University of Basel, Medical Image Analysis Center (MIAC AG), Basel, Switzerland.
¹⁴ Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland.
¹⁵ Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.
¹⁶ Population Health Research Institute, McMaster University, Hamilton, Canada.
¹⁷ Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland. stefanie.aeschbacher@usb.ch.
¹⁸ Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. stefanie.aeschbacher@usb.ch.
¹⁹ Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland. christinestefanie.meyer-zuern@usb.ch.
²⁰ Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. christinestefanie.meyer-zuern@usb.ch.

^# Contributed equally.

Abstract

Background: There is some evidence of reduced major cardiovascular event (MACE) rates associated with moderate coffee consumption in the general population. However, there is concern about the potential risks of coffee consumption in patients with atrial fibrillation (AF). Therefore, we aimed to investigate the association between coffee consumption and MACE in AF patients.

Methods: Data of patients with documented AF enrolled in two large prospective observational multicenter cohort studies (Swiss-AF and Beat-AF) were analyzed. Follow-up information was obtained on a yearly basis. Coffee consumption was categorized into two main groups: "daily" and "not-daily" coffee consumers as well as additional subcategories. The primary endpoint was MACE, defined as a composite of stroke or systemic embolism, myocardial infarction, hospitalization for acute heart failure, and cardiovascular mortality. Secondary endpoints were the individual components of MACE and all-cause mortality. We performed time-updated multivariable adjusted Cox regression analyses to investigate the association between coffee consumption and MACE.

Results: The incidence rate for MACE was 5.09 per 100 person-years (py) in daily and 7.49 per 100 py in not-daily consumers (median follow-up duration: 4.7 years). After adjustment for pre-selected confounding variables, daily coffee consumption was associated with a 23% lower hazard for MACE compared to not-daily consumption (hazard ratio (HR) (95% confidence interval (CI)) 0.77 (0.66; 0.89)). Patients with moderate coffee consumption (2-3 cups/day) had the lowest hazard for MACE compared to patients with not-daily coffee consumption (HR (95% CI) 0.74 (0.63; 0.87)).

Conclusions: In a population of AF patients, daily coffee consumption was associated with a reduced risk for MACE, hospitalization for acute heart failure, and all-cause mortality. The results were inconclusive for stroke or systemic embolism, myocardial infarction, and cardiovascular death. In this analysis, we found no evidence of an unfavourable association of daily coffee consumption in AF Patients with adverse outcome events.

Trial registration: ClinicalTrials.gov Identifier: NCT02105844.

Keywords: All-cause mortality; Atrial fibrillation; Caffeine; Coffee; MACE; Outcome events.

Publication types

Multicenter Study
Observational Study

MeSH terms

Aged
Aged, 80 and over
Atrial Fibrillation* / drug therapy
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / mortality
Coffee* / adverse effects
Female
Hospitalization / statistics & numerical data
Humans
Incidence
Male
Middle Aged
Prospective Studies

Substances

Coffee

Associated data

ClinicalTrials.gov/NCT02105844