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Canadian Journal of Cardiology

Caffeine Intake and Atrial Fibrillation Incidence: Dose Response Meta-analysis of Prospective Cohort Studies

  • Min Cheng
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Zunsong Hu
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Xiangfeng Lu
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Jianfeng Huang
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Dongfeng Gu
    Correspondence
    Corresponding author: Dr Dongfeng Gu, Beili Shi Road 167, Beijing 100037, China. Tel.: +86-10-68331752; fax: +86-10-88363812.
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Published:January 06, 2014DOI:https://doi.org/10.1016/j.cjca.2013.12.026

      Abstract

      Background

      The association between habitual caffeine intake with incident atrial fibrillation (AF) was unknown. We conducted a meta-analysis to investigate the association between chronic exposure of caffeine and the risk of AF and to evaluate the potential dose-response relation.

      Methods

      We searched PubMed, EMBASE, and the Cochrane Library up to November 2013 and references of relevant retrieved articles. Prospective cohort studies were included with relative risk (RR) or hazard ratio and 95% confidence intervals (CIs) for AF according to coffee/caffeine intake.

      Results

      Six prospective cohort studies with 228,465 participants were included. In the primary meta-analysis, caffeine exposure was weakly associated with a reduced risk of AF (RR, 0.90; 95% CI, 0.81-1.01; P = 0.07; I2 = 73%). In subgroup analyses, pooled results from studies with adjustment of potential confounders showed an 11% reduction for low doses (RR, 0.89; 95% CI, 0.80-0.99, P = 0.032; I2 = 30.9%, P = 0.227) and 16% for high doses (RR, 0.84; 95% CI, 0.75-0.94, P = 0.002; I2 = 24.1%, P = 0.267) of caffeine consumption in AF risk. An inverse relation was found between habitual caffeine intake and AF risk (P for overall trend = 0.015; P for nonlinearity = 0.27) in dose-response meta-analysis and the incidence of AF decreased by 6% (RR, 0.94; 95% CI, 0.90-0.99) for every 300 mg/d increment in habitual caffeine intake.

      Conclusions

      It is unlikely that caffeine consumption causes or contributes to AF. Habitual caffeine consumption might reduce AF risk.

      Résumé

      Introduction

      Le lien entre l’apport habituel de caféine et l’incidence de la fibrillation auriculaire (FA) était inconnu. Nous avons mené une méta-analyse pour examiner le lien entre l’exposition chronique à la caféine et le risque de FA, et pour évaluer la relation dose-effet potentielle.

      Méthodes

      Nous avons fouillé PubMed, EMBASE et la Bibliothèque Cochrane jusqu’en novembre 2013 et les références des articles extraits pertinents. Les études de cohorte prospectives avaient inclus le risque relatif (RR) ou le rapport de risque, et les intervalles de confiance (IC) à 95 % de la FA selon l’apport en café et en caféine.

      Résultats

      Six (6) études de cohorte prospectives comportant 228 465 participants avaient été incluses. Dans la méta-analyse principale, l’exposition à la caféine était faiblement associée à la réduction du risque de FA (RR, 0,90; IC à 95 %, 0,81-1,01; P = 0,07; I2 = 73 %). Dans les analyses en sous-groupes, les résultats regroupés des études avec l’ajustement des facteurs de confusion potentiels montraient une réduction du risque de FA de 11 % pour la consommation de caféine à faibles doses (RR, 0,89; IC à 95 %, 0,80-0,99, P = 0,032; I2 = 30,9 %, P = 0,227) et de 16 % pour la consommation de caféine à doses élevées (RR, 0,84; IC à 95 %, 0,75-0,94, P = 0,002; I2 = 24,1 %, P = 0,267). Une relation inverse était observée entre l’apport habituel de caféine et le risque de FA (P pour la tendance globale = 0,015; P pour la non-linéarité = 0,27) dans la méta-analyse dose-effet, et l’incidence de la FA diminuait de 6 % (RR, 0,94; IC à 95 %, 0,90-0,99) à chaque augmentation de 300 mg/j de l’apport habituel de caféine.

      Conclusions

      Il est peu probable que la consommation de caféine cause ou contribue à la FA. La consommation habituelle de caféine pourrait réduire le risque de FA.
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