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Coffee Consumption and Incident Tachyarrhythmias
Quick Takes
- Moderate coffee intake was associated with a small reduced risk of incident arrhythmia.
- The association of coffee intake and incident arrhythmia was not significantly modified by genetic variants that affect caffeine intake.
Study Questions:
Is caffeine intake associated with an increased risk for arrhythmia?
Methods:
This prospective cohort study used data from the UK Biobank, which includes participants from the National Health Service, aged 40-69 years, who reside near one of the 22 assessment centers. Data for the present study were collected between January 1, 2006, and December 31, 2018. From the 502,543 participants, those who were pregnant at study entry, withdrew, or had missing data, were excluded. Daily coffee intake (assessed by questionnaires) and genetic polymorphisms that affect caffeine metabolism were the primary exposures of interest. Coffee intake was grouped into eight categories (from 0 to ≥6 cups daily). The primary outcome was incident cardiac arrhythmia, including atrial fibrillation or flutter, supraventricular tachycardia, ventricular tachycardia, premature atrial complexes, and premature ventricular complexes.
Results:
A total of 386,258 individuals (mean [SD] age, 56 [8] years; 52.3% female) were included in the present study. A median of 2 cups of coffee was consumed per day. During a mean (SD) follow-up of 4.5 (3.1) years, 16,979 participants developed an incident arrhythmia. After adjustment for demographic characteristics, comorbid conditions, and lifestyle habits, each additional cup of habitual coffee consumed was associated with a 3% lower risk of incident arrhythmia (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.96-0.98; p < 0.001). In analyses of each arrhythmia alone, statistically significant associations exhibiting a similar magnitude were observed for atrial fibrillation and/or flutter (HR, 0.97; 95% CI, 0.96-0.98; p < 0.001) and supraventricular tachycardia (HR, 0.96; 95% CI, 0.94-0.99; p = 0.002). Using a caffeine metabolism-related polygenic score of 7 genetic polymorphisms and another method restricted to CYP1A2 rs762551 alone did not reveal any evidence of effect modification. A Mendelian randomization study that used these same genetic variants also revealed no significant association between underlying propensities to differing caffeine metabolism and the risk of incident arrhythmia.
Conclusions:
The investigators concluded that in this prospective cohort study, greater amounts of habitual coffee consumption were inversely associated with a lower risk of arrhythmia, with no evidence that genetically mediated caffeine metabolism affected that association. Mendelian randomization failed to provide evidence that caffeine consumption was associated with arrhythmias.
Perspective:
These data suggest that caffeinated beverages such as coffee do not increase the risk for arrhythmia. However, the associated risk reduction was slight, suggesting coffee does not provide significant protection against arrhythmias.
Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Prevention, Implantable Devices, EP Basic Science, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Diet
Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Flutter, Atrial Premature Complexes, Caffeine, Coffee, Cytochrome P-450 CYP1A2, Diet, Life Style, Polymorphism, Genetic, Primary Prevention, Tachycardia, Supraventricular, Ventricular Premature Complexes
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