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Canadian Journal of Cardiology

Clinical Articles, News & Views

No evidence caffeine consumption contributes to AF

There is no evidence that caffeine consumption causes or contributes to atrial fibrillation (AF), according to a study published recently in the Canadian Journal of Cardiology.1 Habitual caffeine consumption might in fact offer a moderate protective effect against AF, say the authors.1

The authors 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.

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.

“The finding of this study is meaningful,” write the authors. “First, there is no need for concern that habitual caffeine intake may increase AF risk. Second, as atrial fibrosis is an important substrate for AF and caffeine has an antifibrosis property, the finding may pave the way for seeking effective antifibrosis agents for AF management or prompt development of caffeine as an agent for preventing AF,” they add.

London GP Dr Sarah Jarvis commented: “These results provide further evidence that moderate doses of caffeine are well tolerated in patients with arrhythmia and that exposure to levels under 500 mg of caffeine might offer a small protective effect against AF. As the study predominantly looked at the effect of coffee consumption on AF, the one in four people over the age of 40 most at risk of developing the condition can take comfort knowing their daily consumption of coffee is not increasing this risk.”

References

1. Cheng M, Hu Z, Lu X, Huang J, Gu D. Caffeine intake and atrial fibrillation incidence: dose response meta-analysis of prospective cohort studies. Can J Cardiol 2014;30:448–54. http://dx.doi.org/10.1016/j.cjca.2013.12.026

Published on: April 30, 2014

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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