Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
PLoS One. 2019 Jan 17;14(1):e0210959. doi: 10.1371/journal.pone.0210959. eCollection 2019.
Physical exertion and caffeine consumption are associated with acute myocardial infarction (MI). However, physical exertion and caffeine consumption have not been examined as immediate triggers of MI in low and middle-income countries.
Using a self-matched case-crossover design, we examined the acute risk of MI in the hour following episodes of physical exertion, caffeinated coffee, and tea consumption among MI survivors in Thailand.
A total of 506 Thai participants (women = 191, men = 315) were interviewed between 2014 and 2017 after sustaining an acute MI. We compared each subject's exposure to physical exertion and consumption of caffeine- containing beverages in the hour preceding the onset of MI with the subject's expected usual frequency in the prior year to calculate relative risks (RRs) and 95% confidence intervals (95%CIs).
Of the 506 participants, 47 (9.3%) engaged in moderate or heavy physical exertion, 6 (1.2%) consumed tea, and 21 (4.2%) consumed coffee within the hour before MI. The relative risk of MI after moderate or heavy physical exertion was 3.0 (95% CI 2.2-4.2) compared to periods of no exertion, with a higher risk among more sedentary participants compared to active participants. Compared to times with no caffeinated beverage consumption, there was a higher risk of MI in the hour following consumption of caffeinated tea (RR = 3.7; 95%CI: 1.5-9.3) and coffee (RR = 2.3; 95%CI: 1.4-3.6).
Physical exertion, coffee and tea consumption were associated with a higher risk of MI in the subsequent hour compared to times when the participants were sedentary or did not consume caffeinated beverages. Our study identifies high-risk populations for targeted screening and intervention to prevent acute MI.
体力活动和咖啡因摄入与急性心肌梗死（MI）有关。然而，在中低收入国家，体力活动和咖啡因摄入尚未被视为 MI 的即时触发因素。
本研究使用自我匹配的病例交叉设计，在泰国 MI 幸存者中，检查体力活动、含咖啡因咖啡和茶摄入后 1 小时内 MI 的急性发病风险。
共有 506 名泰国参与者（女性=191 人，男性=315 人）于 2014 年至 2017 年期间在急性 MI 后接受访谈。我们将每位受试者在 MI 发作前 1 小时内的体力活动和含咖啡因饮料的摄入情况与受试者前一年的预期频率进行比较，以计算相对风险（RR）和 95%置信区间（95%CI）。
在 506 名参与者中，有 47 名（9.3%）进行了中等或剧烈体力活动，6 名（1.2%）饮用了茶，21 名（4.2%）饮用了咖啡。与无体力活动相比，中等或剧烈体力活动后 MI 的相对风险为 3.0（95%CI 2.2-4.2），与久坐不动的参与者相比，活跃参与者的风险更高。与无含咖啡因饮料摄入相比，饮用含咖啡因茶（RR=3.7；95%CI：1.5-9.3）和咖啡（RR=2.3；95%CI：1.4-3.6）后 1 小时内发生 MI 的风险更高。
与参与者久坐不动或不饮用含咖啡因饮料的时间相比，体力活动、咖啡和茶的摄入与随后 1 小时内 MI 的发病风险增加相关。我们的研究确定了高危人群，以便进行有针对性的筛查和干预，以预防急性 MI。
