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(Circulation. 2007;116:2944-2951.)
© 2007 American Heart Association, Inc.

Epidemiology

Coffee Consumption and Risk of Cardiovascular Events After Acute Myocardial Infarction

Results From the GISSI (Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico)-Prevenzione Trial

Maria Giuseppina Silletta, MSc; RosaMaria Marfisi, MS; Giacomo Levantesi, MD; Alessandro Boccanelli, MD; Carmelo Chieffo, MD; MariaGrazia Franzosi, MSc; Enrico Geraci, MD; Aldo Pietro Maggioni, MD; Gianluigi Nicolosi, MD; Carlo Schweiger, MD; Luigi Tavazzi, MD; Gianni Tognoni, MD; Roberto Marchioli, MD, on behalf of the GISSI-Prevenzione Investigators^*

From the Laboratory of Clinical Epidemiology of Cardiovascular Disease (M.G.S., R. Marfisi, G.L., R. Marchioli, G.T.), Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy; Ospedale San Giovanni (A.B.), Rome, Italy; Ospedale Civile, Caserta (C.C.), Italy; Department of Cardiovascular Research (M.F.), Istituto Mario Negri, Milan, Italy; Ospedale Cervello (E.G.), Palermo, Italy; Centro Studi ANMCO (A.P.M.), Florence, Italy; Ospedale Santa Maria degli Angeli (G.N.), Pordenone, Italy; Ospedale Civile, Presidio di Riabilitazione (C.S.), Passirana di Rho, Milan, Italy; and Fondazione IRCCS Policlinico San Matteo (L.T.), Pavia, Italy.

Reprint requests to Roberto Marchioli, MD, Consorzio Mario Negri Sud, Via Nazionale 8/A, 66030, Santa Maria Imbaro, Italy. E-mail marchioli{at}negrisud.it

Received May 9, 2007; accepted October 19, 2007.

Background— The relation between coffee consumption and cardiovascular disease has been studied extensively, but results are still debated. In addition, little evidence is available on patients with established coronary heart disease.

Methods and Results— Prospectively ascertained information among 11 231 Italian patients (9584 males and 1647 females) with recent (3 months) myocardial infarction enrolled in the GISSI (Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico)-Prevenzione trial was used. Usual dietary habits were assessed at baseline and updated at 0.5 and 1.5 years. Coffee consumption was categorized as never/almost never, <2 cups per day, 2 to 4 cups per day, and >4 cups per day. Medication use and fasting glucose were assessed at 0.5, 1, 1.5, 2.5, and 3.5 years. Risk was evaluated with Cox proportional hazards with time-varying covariates. The main outcome measure was the cumulative incidence of cardiovascular events (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke). A total of 1167 cardiovascular events occurred during 36 961 person-years of follow-up. After multivariable adjustment for potential confounders in the time-dependent analysis, the relative risk of cardiovascular events across categories of coffee consumption was 1.02 (95% CI 0.87 to 1.20) for <2 cups per day, 0.91 (95% CI 0.75 to 1.09) for 2 to 4 cups per day, and 0.88 (95% CI 0.64 to 1.20) for >4 cups per day compared with abstainers (P for trend=0.18). Ultimately, coffee consumption did not change the risk of coronary heart disease events, stroke, and sudden death.

Conclusions— No association between moderate coffee intake and cardiovascular events was observed in post–myocardial infarction patients.

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CLINICAL PERSPECTIVE