心房颤动患者的咖啡摄入量与不良心血管事件
Coffee consumption and adverse cardiovascular events in patients with atrial fibrillation.
作者信息
Iten Vasco, Herber Elena, Coslovsky Michael, Hennings Elisa, Paladini Rebecca E, Reichlin Tobias, Rodondi Nicolas, Müller Andreas S, Stauber Annina, Beer Juerg H, Brenner Roman, Conte Giulio, Kobza Richard, Di Valentino Marcello, Bedoya Patricia Chocano, Moradi Freschteh, Sinnecker Tim, Bonati Leo H, Kühne Michael, Osswald Stefan, Conen David, Aeschbacher Stefanie, Zuern Christine S
机构信息
Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
出版信息
BMC Med. 2024 Dec 18;22(1):593. doi: 10.1186/s12916-024-03817-x.
BACKGROUND
There is some evidence of reduced major cardiovascular event (MACE) rates associated with moderate coffee consumption in the general population. However, there is concern about the potential risks of coffee consumption in patients with atrial fibrillation (AF). Therefore, we aimed to investigate the association between coffee consumption and MACE in AF patients.
METHODS
Data of patients with documented AF enrolled in two large prospective observational multicenter cohort studies (Swiss-AF and Beat-AF) were analyzed. Follow-up information was obtained on a yearly basis. Coffee consumption was categorized into two main groups: "daily" and "not-daily" coffee consumers as well as additional subcategories. The primary endpoint was MACE, defined as a composite of stroke or systemic embolism, myocardial infarction, hospitalization for acute heart failure, and cardiovascular mortality. Secondary endpoints were the individual components of MACE and all-cause mortality. We performed time-updated multivariable adjusted Cox regression analyses to investigate the association between coffee consumption and MACE.
RESULTS
The incidence rate for MACE was 5.09 per 100 person-years (py) in daily and 7.49 per 100 py in not-daily consumers (median follow-up duration: 4.7 years). After adjustment for pre-selected confounding variables, daily coffee consumption was associated with a 23% lower hazard for MACE compared to not-daily consumption (hazard ratio (HR) (95% confidence interval (CI)) 0.77 (0.66; 0.89)). Patients with moderate coffee consumption (2-3 cups/day) had the lowest hazard for MACE compared to patients with not-daily coffee consumption (HR (95% CI) 0.74 (0.63; 0.87)).
CONCLUSIONS
In a population of AF patients, daily coffee consumption was associated with a reduced risk for MACE, hospitalization for acute heart failure, and all-cause mortality. The results were inconclusive for stroke or systemic embolism, myocardial infarction, and cardiovascular death. In this analysis, we found no evidence of an unfavourable association of daily coffee consumption in AF Patients with adverse outcome events.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02105844.
背景
有证据表明，普通人群中适度饮用咖啡与主要心血管事件（MACE）发生率降低有关。然而，人们担心心房颤动（AF）患者饮用咖啡存在潜在风险。因此，我们旨在研究AF患者饮用咖啡与MACE之间的关联。
方法
分析了两项大型前瞻性观察性多中心队列研究（瑞士AF研究和Beat-AF研究）中记录的AF患者的数据。每年获取随访信息。咖啡饮用情况分为两个主要组：“每日”和“非每日”咖啡饮用者以及其他子类别。主要终点是MACE，定义为中风或全身性栓塞、心肌梗死、急性心力衰竭住院和心血管死亡的综合指标。次要终点是MACE的各个组成部分和全因死亡率。我们进行了时间更新的多变量调整Cox回归分析，以研究咖啡饮用与MACE之间的关联。
结果
“每日”饮用者的MACE发生率为每100人年5.09例，“非每日”饮用者为每100人年7.49例（中位随访时间：4.7年）。在对预先选定的混杂变量进行调整后，与“非每日”饮用相比，“每日”饮用咖啡与MACE风险降低23%相关（风险比（HR）（95%置信区间（CI））0.77（0.66；0.89））。与“非每日”饮用咖啡的患者相比，适度饮用咖啡（每天2 - 3杯）的患者发生MACE的风险最低（HR（95%CI）0.74（0.63；0.87））。
结论
在AF患者群体中，“每日”饮用咖啡与MACE风险降低、急性心力衰竭住院风险降低和全因死亡率降低相关。对于中风或全身性栓塞、心肌梗死和心血管死亡，结果尚无定论。在本分析中，我们未发现AF患者“每日”饮用咖啡与不良结局事件之间存在不利关联的证据。
试验注册
ClinicalTrials.gov标识符：NCT02105844。
Zotero 插件