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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References
- Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC).Eur Heart J. 2010; 31 ([erratum in 2011;32:1172]): 2369-2429
- 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.Circulation. 2011; 123: e269-e367
- Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.JAMA. 2001; 285: 2370-2375
- Association of coffee drinking with total and cause-specific mortality.N Engl J Med. 2012; 366: 1891-1904
- The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis.Am J Clin Nutr. 2011; 94: 1113-1126
- Habitual coffee consumption and risk of heart failure: a dose-response meta-analysis.Circ Heart Fail. 2012; 5: 401-405
- Effects of habitual coffee consumption on cardiometabolic disease, cardiovascular health, and all-cause mortality.J Am Coll Cardiol. 2013; 62: 1043-1051
- A meta-analysis of prospective studies of coffee consumption and mortality for all causes, cancers and cardiovascular diseases.Eur J Epidemiol. 2013; 28: 527-539
- Caffeine and ventricular arrhythmias. An electrophysiological approach.JAMA. 1990; 264: 2236-2240
- The effect of caffeine on ventricular ectopic activity in patients with malignant ventricular arrhythmia.Arch Intern Med. 1989; 149: 637-639
- Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta-analysis of observational studies.Heart. 2013; 99: 1383-1389
- Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.JAMA. 2000; 283: 2008-2012
- Methods for trend estimation from summarized dose-response data, with applications to meta-analysis.Am J Epidemiol. 1992; 135: 1301-1309
- Meta-analysis for linear and nonlinear dose-response relations: examples, an evaluation of approximations, and software.Am J Epidemiol. 2012; 175: 66-73
- Caffeine content of specialty coffees.J Anal Toxicol. 2003; 27: 520-522
- Caffeine and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.Am J Clin Nutr. 2005; 81: 578-582
- Caffeine consumption and incident atrial fibrillation in women.Am J Clin Nutr. 2010; 92: 509-514
- Coffee, caffeine, and risk of hospitalization for arrhythmias.Perm J. 2011; 15: 19-25
- Dietary factors and incident atrial fibrillation: the Framingham Heart Study.Am J Clin Nutr. 2011; 93: 261-266
- Coffee consumption and mortality after acute myocardial infarction: the Stockholm Heart Epidemiology Program.Am Heart J. 2009; 157: 495-501
- Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors.J Intern Med. 2001; 250: 382-389
- The confounded relation of coffee drinking to coronary artery disease.Am J Cardiol. 2008; 101: 825-827
- Cigarette smoking and risk of atrial fibrillation: the Rotterdam Study.Am Heart J. 2008; 156: 1163-1169
- An evaluation of the change in electrocardiographic P-wave variables after acute caffeine ingestion in normal volunteers.J Clin Pharm Ther. 2001; 26: 145-148
- Evaluation of electrocardiographic and hemodynamic effects of caffeine with acute dosing in healthy volunteers.Pharmacotherapy. 2001; 21: 437-442
- Caffeine as a possible cause of ventricular arrhythmias during the healing phase of acute myocardial infarction.Am J Cardiol. 1987; 59: 1024-1028
- Coffee acutely increases sympathetic nerve activity and blood pressure independently of caffeine content: role of habitual versus nonhabitual drinking.Circulation. 2002; 106: 2935-2940
- Association of coffee and caffeine consumption with fatty liver disease, nonalcoholic steatohepatitis, and degree of hepatic fibrosis.Hepatology. 2012; 55: 429-436
- Regular coffee but not espresso drinking is protective against fibrosis in a cohort mainly composed of morbidly obese European women with NAFLD undergoing bariatric surgery.J Hepatol. 2012; 57: 1090-1096
- Coffee attenuates fibrosis by decreasing the expression of TGF-beta and CTGF in a murine model of liver damage.J Appl Toxicol. 2013; 33: 970-979
- Caffeine prevents experimental liver fibrosis by blocking the expression of TGF-β.Eur J Gastroenterol Hepatol. 2014; 26: 164-173
- Pharmacological application of caffeine inhibits TGF-beta-stimulated connective tissue growth factor expression in hepatocytes via PPARgamma and SMAD2/3-dependent pathways.J Hepatol. 2008; 49: 758-767
- Elevated pre-operative serum peptides for collagen I and III synthesis result in post-surgical atrial fibrillation.J Am Coll Cardiol. 2012; 60: 1799-1806
- Impact of left atrial fibrosis and left atrial size on the outcome of catheter ablation for atrial fibrillation.Heart. 2011; 97: 1847-1851
- Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation.J Am Coll Cardiol. 2008; 51: 802-809
Article info
Publication history
Published online: January 06, 2014
Accepted:
December 24,
2013
Received:
November 21,
2013
Footnotes
See page 453 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
