Mukamal Kenneth J, Alert Marissa, Maclure Malcolm, Muller James E, Mittleman Murray A
Beth Israel Deaconess Medical Center, Division of General Medicine and Primary Care Research Program, Brookline, MA 02446, USA.
J Am Coll Nutr. 2006 Dec;25(6):472-9. doi: 10.1080/07315724.2006.10719561.
Tea consumption is associated with lower post-infarct mortality among patients with acute myocardial infarction. We previously found preliminary evidence that tea consumption may also be associated with lower risk of infarct-related ventricular arrhythmias.
Between 1989 and 1996, 3882 subjects with AMI were enrolled in the two phases of the Determinants of Myocardial Infarction Onset Study a median of four days after admission. Trained interviewers assessed self-reported usual tea and coffee consumption during the year prior to infarction with a standardized questionnaire. We examined the prevalence of ventricular arrhythmias in the two phases of the study separately and together.
Among the 1912 patients with complete information in the first phase, the prevalence of ventricular arrhythmias was 16% among abstainers from tea, 11% among moderate tea drinkers (<14 cups per week), and 14% among heavier tea drinkers (> or =14 cups per week) (p homogeneity = 0.03). Among the 1791 patients with comparable information in the second phase, the corresponding prevalence rates were 11%, 8%, and 8%, respectively (p = 0.06). When the phases were combined, the adjusted odds ratios for VA were 0.7 (95% confidence interval, 0.6-0.9) among moderate tea drinkers and 0.9 (95% confidence interval, 0.7-1.2) among heavier tea drinkers. The findings were of similar direction for both ventricular tachycardia and fibrillation. In contrast, there was higher risk of VA with increasing coffee intake (odds ratio for >14 cups per week 1.3; 95% confidence interval, 1.0-1.7; p trend 0.02).
Moderate tea intake is associated with a lower prevalence, and higher coffee intake with a slightly higher prevalence, of ventricular arrhythmias among patients hospitalized with acute myocardial infarction. If the association with tea intake is confirmed, it may suggest new approaches to prevention of ischemia-related arrhythmias.
急性心肌梗死患者中，饮茶与较低的梗死后死亡率相关。我们之前发现初步证据表明，饮茶可能还与较低的梗死相关室性心律失常风险有关。
在1989年至1996年期间，3882名急性心肌梗死患者在入院后中位数四天时被纳入心肌梗死发病决定因素研究的两个阶段。经过培训的访员使用标准化问卷评估梗死前一年自我报告的日常茶和咖啡饮用量。我们分别及综合研究的两个阶段检查室性心律失常的患病率。
在第一阶段有完整信息的1912名患者中，不饮茶者室性心律失常患病率为16%，适度饮茶者（每周<14杯）为11%，重度饮茶者（每周≥14杯）为14%（p齐性=0.03）。在第二阶段有可比信息的1791名患者中，相应的患病率分别为11%、8%和8%（p=0.06）。当两个阶段合并时，适度饮茶者发生室性心律失常的校正比值比为0.7（95%置信区间，0.6-0.9），重度饮茶者为0.9（95%置信区间，0.7-1.2）。室性心动过速和颤动的研究结果方向相似。相比之下，随着咖啡摄入量增加，室性心律失常风险更高（每周>14杯的比值比为1.3；95%置信区间，1.0-1.7；p趋势=0.02）。
急性心肌梗死住院患者中，适度饮茶与较低的室性心律失常患病率相关，而较高的咖啡摄入量与略高的患病率相关。如果与饮茶的关联得到证实，可能提示预防缺血相关心律失常的新方法。
