Nutritional Epidemiology The J-Shaped Effect of Coffee Consumption on the Risk of Developing Acute Coronary Syndromes : The CARDIO 2000 Case-Control Study 1 , 2

The effect of coffee consumption on cardiovascular disease has been debated for many years. In this work, we evaluated the association between coffee consumption and the risk of developing acute coronary syndromes, based on a random sample of 848 patients with their first coronary heart disease event and 1078 frequency-matched controls with no cardiovascular disease in their medical history, from the entire country. The multivariate analysis raises a J-shaped association between the risk of developing acute coronary syndromes and the quantity of coffee consumed per day. In particular, the odds ratios for moderate ( 300 mL/d), heavy (300–600 mL/d), and very heavy ( 600 mL/d), consumption, relative to no consumption, were 0.69 (95% CI, 0.50–0.86), 1.56 (95% CI, 1.10–2.34) and 3.10 (95% CI, 1.82–5.26), respectively, after controlling for the presence of hypertension, hypercholesterolemia, diabetes mellitus, family history of premature coronary heart disease, physical activity status, smoking habits, BMI, alcohol consumption, triglycerides, consumption of several food items, depression scale score and education status. The suggested J-shaped association between coffee consumption and the risk of developing acute coronary syndromes may partially explain the conflicting results from other studies in the past. J. Nutr. 133: 3228–3232, 2003.