Chieti, Italy - A new analysis of the GISSI-Prevenzione trial shows that moderate coffee intake does not appear to have any effect on future cardiovascular events in patients who have already had an MI. Dr Maria Giuseppina Silletta (Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy) and colleagues report their results online December 3, 2007 in Circulation.
Silletta stressed to heartwire, however, that the findings can really be applied only to patients eating a Mediterranean diet who drink coffee prepared in the Italian way. Most of the participants in this study drank mocha or espresso coffee, which is unfiltered—the ground coffee beans are in contact with hot water for only a very short time, Silletta explained.
“We will tell patients that it is no problem for them to drink a moderate amount of coffee (two to four cups per day) after a heart attack, there is no cause for concern,” she said. But she noted that her team could not draw conclusions about very high coffee intake because of the small number of patients included in this category.
First to evaluate effects of coffee on a large prospective cohort of CHD patients
The Italian researchers explain that many studies have looked at the association between coffee consumption and risk of cardiovascular disease, “but the issue remains controversial.” Case-control studies suggest a harmful effect of coffee drinking on the risk of CHD, whereas prospective cohort studies show conflicting findings. And more recent studies have shown that coffee consumption may lower the risk of type 2 diabetes, they say.
But evidence is scarce on the association between coffee drinking and cardiovascular events among patients with documented CVD, they point out. Hence they decided to analyze data from a large cohort of patients who had had an MI and were enrolled in the GISSI-Prevenzione trial.
In their analysis, they included 11 231 patients with recent MI (within past three months), the majority of whom were male (n=9584). Usual dietary habits were assessed at baseline and updated at 0.5 and 1.5 years. Coffee consumption was categorized as never/almost never, low (less than two cups per day), moderate (two to four cups per day), or high (more than four cups per day).
The main outcome measure was the cumulative incidence of cardiovascular events (cardiovascular death, nonfatal MI, and nonfatal stroke). A total of 1167 events occurred during the three-and-a-half-year follow-up, with no significant differences found between the various categories of coffee drinker.
Coffee consumption and relative risk of CV events among 11 231 participants in the GISSI-Prevenzione trial
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Coffee consumption
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Subjects, na
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CV events, n
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Multivariable adjusted relative riskb
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p for trend
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|
Never/almost never
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2286
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210
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1.00
|
|
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<2 cup/d | |