Transient Exposure to Coffee as a Trigger of a First Nonfatal Myocardial Infarction

• Published in: Epidemiology (Cambridge, Mass.) Mass.), 2006-09, Vol.17 (5), p.506-511
• Main Authors: Baylin, Ana, Hernandez-Diaz, Sonia, Kabagambe, Edmond K., Siles, Xinia, Campos, Hannia
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Blood pressure; Caffeine - adverse effects; Central Nervous System Stimulants - adverse effects; Coffee; Coffee - adverse effects; Coronary artery disease; Costa Rica - epidemiology; Cross-Over Studies; Disease risk; Epidemiology; Feeding Behavior - physiology; Female; Food intake; Humans; Hypertension; Life Style; Male; Middle Aged; Myocardial infarction; Myocardial Infarction - chemically induced; Myocardial Infarction - epidemiology; Predisposing factors; Questionnaires; Risk; Surveys and Questionnaires
• ISSN: 1044-3983; 1531-5487
• DOI: 10.1097/01.ede.0000229444.55718.96

Background: The effects of coffee on myocardial infarction are uncertain. We hypothesize that coffee in the presence of predisposing factors can induce a cascade of events that, through sympathetic nervous activation, can induce the onset of myocardial infarction. Methods: We recruited 503 incident cases of nonfatal myocardial infarction between 1994 and 1998 in Costa Rica. We used a case-crossover design to calculate relative risks (RRs) and 95% confidence intervals (95% CIs). Results: The RR of myocardial infarction in the hour after coffee intake was 1.49 (95% CI = 1.17-1.89). Occasional coffee drinkers (≤1 cup/day, n = 103) had a RR of myocardial infarction of 4.14 (2.03-8.42), moderate coffee drinkers (2-3 cups/day, n = 280) had a RR of 1.60 (1.16-2.21), and heavy coffee drinkers (≥4 cups/d, n = 120) had a RR of 1.06 (0.69-1.63; P = 0.006, test of homogeneity). Patients with 3 or more risk factors (n = 101) had a RR of myocardial infarction of 2.10 (1.30-3.39), whereas patients with fewer than 3 risk factors (n = 396) had a RR of 1.39 (1.04-1.82; P = 0.15, test of homogeneity); and RR was 1.72 (1.30-2.30) among sedentary patients compared with 1.07 (0.66-1.72) among nonsedentary (P = 0.10, test of homogeneity). Conclusions: The findings indicate that coffee intake may trigger myocardial infarction. The association is particularly strong among people with light/occasional intake of coffee (≤1 cup/day), with sedentary lifestyle, or with 3 or more risk factors for coronary heart disease.