Coffee Consumption and Risk of Atrial Fibrillation in the Physicians’ Health Study

Background Although coffee consumption is often reported as a trigger for atrial fibrillation (AF) among patients with paroxysmal AF, prospective studies on the relation of coffee consumption with AF risk have been inconsistent. Hence, we sought to assess the association between coffee consumption and risk of AF in men. Methods and Results We prospectively studied men who participated in the Physicians’ Health Study (N=18 960). Coffee consumption was assessed through self‐reported food frequency questionnaires. The incidence of AF was assessed through annual questionnaires and validated through review of medical records in a subsample. Cox proportional hazard models were used to calculate hazard ratios and 95% CIs of AF. The average age was 66.1 years. A total of 2098 new cases of AF occurred during a mean follow‐up of 9 years. Hazard ratios (95% CI) of AF were 1.0 (reference), 0.85 (0.71‐1.02), 1.07 (0.88‐1.30), 0.93 (0.74‐1.17), 0.85 (0.74‐0.98), 0.86 (0.76‐0.97), and 0.96 (0.80‐1.14) for coffee consumption of rarely/never, ≤1 cup/week, 2 to 4 cups/week, 5 to 6 cups/week, 1 cup/day, 2 to 3 cups/day, and 4+ cups/day, respectively; adjusting for age, smoking, alcohol intake, and exercise (P for nonlinear trend=0.01). In a secondary analysis the multivariable adjusted hazard ratio (95% CI) of AF per standard deviation (149‐mg) change in caffeine intake was 0.97 (0.92‐1.02). Conclusions Our data suggest a lower risk of AF among men who reported coffee consumption of 1 to 3 cups/day.

[1]  David M. Smith,et al.  All-Cause, Stroke-, and Bleed-Specific Healthcare Costs: Comparison among Patients with Non-Valvular Atrial Fibrillation (NVAF) Newly Treated with Dabigatran or Warfarin , 2017, American Journal of Cardiovascular Drugs.

[2]  A. Tjønneland,et al.  Risk of atrial fibrillation associated with coffee intake: Findings from the Danish Diet, Cancer, and Health study , 2016, European journal of preventive cardiology.

[3]  S. Larsson,et al.  Coffee consumption is not associated with increased risk of atrial fibrillation: results from two prospective cohorts and a meta-analysis , 2015, BMC Medicine.

[4]  Sudha Seshadri,et al.  50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study , 2015, The Lancet.

[5]  M. Ezekowitz,et al.  2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. , 2014, Circulation.

[6]  M. Ezekowitz,et al.  2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. , 2014, Circulation.

[7]  F. Violi,et al.  Antioxidants for prevention of atrial fibrillation: a potentially useful future therapeutic approach? A review of the literature and meta-analysis. , 2014, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[8]  F. Sedaghat-Hamedani,et al.  Antioxidant supplementations for prevention of atrial fibrillation after cardiac surgery: an updated comprehensive systematic review and meta-analysis of 23 randomized controlled trials. , 2014, Interactive cardiovascular and thoracic surgery.

[9]  Tommy Andersson,et al.  All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995–2008: a Swedish nationwide long-term case–control study , 2013, European heart journal.

[10]  C. Morand,et al.  Evidence for a protective effect of polyphenols-containing foods on cardiovascular health: an update for clinicians , 2012, Therapeutic advances in chronic disease.

[11]  C. Albert,et al.  Caffeine consumption and incident atrial fibrillation in women. , 2010, The American journal of clinical nutrition.

[12]  Nancy R Cook,et al.  Relation of vigorous exercise to risk of atrial fibrillation. , 2009, The American journal of cardiology.

[13]  H. Duff,et al.  Caffeine induces Ca2+ release by reducing the threshold for luminal Ca2+ activation of the ryanodine receptor. , 2008, The Biochemical journal.

[14]  J. Vinson,et al.  Coffee and cardiovascular disease: in vitro, cellular, animal, and human studies. , 2007, Pharmacological research.

[15]  M. Movahed,et al.  Diabetes mellitus is a strong, independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease. , 2005, International journal of cardiology.

[16]  W. Maisel,et al.  Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. , 2003, The American journal of cardiology.

[17]  J. Auer,et al.  Subclinical hyperthyroidism as a risk factor for atrial fibrillation. , 2001, American heart journal.

[18]  L. Wilhelmsen,et al.  Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors , 2001, Journal of internal medicine.

[19]  C. Hennekens,et al.  Design of Physicians' Health Study II--a randomized trial of beta-carotene, vitamins E and C, and multivitamins, in prevention of cancer, cardiovascular disease, and eye disease, and review of results of completed trials. , 2000, Annals of epidemiology.

[20]  D. Levy,et al.  Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. , 1994, JAMA.

[21]  G A Colditz,et al.  Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. , 1992, American journal of epidemiology.

[22]  W. Willett,et al.  Reproducibility and validity of a semiquantitative food frequency questionnaire. , 1985, American journal of epidemiology.

[23]  D. Stephenson,et al.  Effects of caffeine on Ca-activated force production in skinned cardiac and skeletal muscle fibres of the rat , 1983, Pflügers Archiv.

[24]  D Robertson,et al.  Effects of caffeine on plasma renin activity, catecholamines and blood pressure. , 1978, The New England journal of medicine.

[25]  Jennifer G. Robinson,et al.  ACCF/AHA TASK FORCE MEMBERS , 2013 .

[26]  A. Klatsky,et al.  Coffee, caffeine, and risk of hospitalization for arrhythmias. , 2011, The Permanente journal.

[27]  D. Parish,et al.  Obesity and the risk of new-onset atrial fibrillation. , 2005, JAMA.

[28]  Final report on the aspirin component of the ongoing Physicians' Health Study. , 1989, The New England journal of medicine.