Coffee and Atrial Fibrillation: What's the (True) Link?
A new study finds that higher caffeine intake may decrease the risk of patients developing new onset atrial fibrillation.
Caffeine in a wide variety of forms has been ingested for centuries for both its therapeutic properties and its social leavening effects. Research has also associated caffeine with human ills ranging from anxiety disorders to cancer and GI maladies to cardiac arrhythmias. In fact, physicians and the general public alike believe caffeine consumption induces cardiac dysrhythmias. But research on the link has to date been inconclusive.
A new study, summarized in the 6 slides below, took a meta-analytic approach to determine the true nature of the link between atrial fibrillation (AF) and caffeine consumption.
Caffeine in a wide variety of forms has been ingested for centuries for both its therapeutic properties and its social leavening effects. Research has also associated caffeine with human ills ranging from anxiety disorders to cancer and GI maladies to cardiac arrhythmias. In fact, physicians and the general public alike believe caffeine consumption induces cardiac dysrhythmias. But research on the link has to date been inconclusive.
A new study, summarized in the 6 slides above, took a meta-analytic approach to determine the true nature of the link between atrial fibrillation (AF) and caffeine consumption.
Coffee and Atrial Fibrillation, in Brief. Caffeine is thought to potentially trigger AF via neurohormonal and sympathetic nervous system activation, although studies have failed to confirm this. So, what exactly is the nature of the link between new onset AF and caffeine consumption?
Meta-analysis of Coffee Consumption and New Onset AF. Authors conducted a meta-analysis including a dose-response analysis to assess the link between caffeine and AF incidence. Data was collected from 8 studies covering 176 675 patients (5.7% with AF) with authors assuming caffeine content consumed was 140 mg in a 12 oz cup. The control variable was <2 cups of coffee a day.
Risk of New Onset AF Decreased with Increased Coffee Consumption. Study found that AF risk was higher when patients consumed <4 cups of coffee/day vs ≥4 cups/day and lower AF risk was associated with ≥4 cups/day vs control. No significant difference in AF incidence for <2 cups/day vs >2 cups/day. These findings suggest the benefits for higher caffeine consumption.
Clinical Implications:
● Results suggest caffeine does not increase the risk of AF, but it needs to be confirmed in RCT.
● Providers should remain aware of arrhythmogenic potential of highly caffeinated energy drinks, especially in children and teens.
● Results should be interpreted based on individual variability; patients who experience caffeine-related symptoms should consider refraining from consumption.
Take Home Points:
● First meta-analysis to standardize caffeine intake found higher caffeine consumption linked to decreased risk of new onset AF.
● Higher risk of new onset AF linked to lower caffeine consumption.
● Results suggest benefit for higher caffeine consumption, but require RCT for confirmation.
Source: Abdelfattah R, Kamran H, Lazar J, Kassotis J. Does caffeine consumption increase the risk of new-onset atrial fibrillation? Cardiology. 2018;140:106-114.
