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咖啡摄入与心房颤动事件的相关性(来自动脉粥样硬化多民族研究[MESA])。

Association Between Coffee Consumption and Incident Atrial Fibrillation (from the Multi-Ethnic Study of Atherosclerosis [MESA]).

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Am J Cardiol. 2023 Jan 1;186:5-10. doi: 10.1016/j.amjcard.2022.10.025. Epub 2022 Nov 3.

Abstract

This study aimed to elucidate a potential dose-dependent relation between coffee intake and atrial fibrillation (AF) incidence in a multi-ethnic setting. Previous studies were comprised mainly of White populations, and an exploration of dose dependency is limited. To address these gaps, we analyzed the Multi-Ethnic Study of Atherosclerosis data, a prospective cohort study. In the primary analysis, we crudely divided patients into 3 groups: nonconsumers, 1 to 3 cups/month, and ≥1 cup/week. For the secondary analysis, we stratified the cohort into 9 groups of gradual increments for coffee consumption. A multivariable cox proportional hazards regression model was adjusted for 6 potential confounders: age, gender, smoking, hypertension, diabetes mellitus, and alcohol. Subjects who drank ≥1 cup of coffee/week had a higher incidence of AF (adjusted hazard ratio 1.40, p = 0.015) than nonconsumers. Furthermore, in the secondary analysis, there was an overall trend, albeit not consistent, of increasing adjusted hazard ratio with progressively increasing doses of coffee in the following groups: 1 to 3 cups/month, 2 to 4 cups/week, 2 to 3 cups/day and ≥6 cups/day. Notably, AF incidence was highest (9.8%) for the group consuming the most coffee, that is, ≥6 cups/day (p = 0.02). Stratification by race/ethnicity suggested the results may be driven by White and Hispanic rather than Black or Chinese-American subgroups. In conclusion, the findings suggest an association between coffee consumption and incident AF in contrast to most previous studies.

摘要

本研究旨在阐明在多民族环境中,咖啡摄入量与心房颤动(AF)发生率之间可能存在的剂量依赖性关系。先前的研究主要包括白种人群,对剂量依赖性的探索有限。为了解决这些差距,我们分析了多民族动脉粥样硬化研究的数据,这是一项前瞻性队列研究。在主要分析中,我们粗略地将患者分为 3 组:非饮用者、每月 1-3 杯和每周≥1 杯。对于二次分析,我们将队列分为 9 组,咖啡摄入量逐渐增加。使用多变量 cox 比例风险回归模型调整了 6 个潜在混杂因素:年龄、性别、吸烟、高血压、糖尿病和饮酒。每周饮用≥1 杯咖啡的患者发生 AF 的风险更高(调整后的危险比为 1.40,p=0.015)。此外,在二次分析中,尽管不一致,但随着咖啡剂量的逐渐增加,以下组别的调整后危险比呈总体趋势:每月 1-3 杯、每周 2-4 杯、每天 2-3 杯和每天≥6 杯。值得注意的是,饮用最多咖啡(即每天≥6 杯)的组 AF 发生率最高(9.8%)(p=0.02)。按种族/族裔分层表明,结果可能是由白人和西班牙裔人群驱动的,而不是黑人或华裔美国人亚组。总之,与大多数先前的研究相比,这些发现表明咖啡消费与新发 AF 之间存在关联。

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