Coffee and alcohol consumption as triggering factors for sudden cardiac death: case-crossover study.
OBJECTIVE
To estimate the relative risk of triggering sudden cardiac death after coffee or alcohol consumption in out-of-hospital sudden cardiac death victims.


METHODS
A case-crossover design with usual frequency approach was used and the study population included persons who died out of hospital due to sudden cardiac death. By mailing 2 questionnaires, 1 to the family members of the deceased and the other to the attending physician, necessary data on the mode of cardiac death, life style, health, and several socio-demographic variables were obtained. Cases were those who died of sudden cardiac death within 1 hour after coffee consumption or within 2 hours after ingesting alcohol; but controls were those who died in the hours when they were not exposed to these stimulans. The relative risk of dying within exposed hours in comparison to non-exposed hours was parameter estimated for each risk factor.


RESULTS
Among 309 sudden cardiac death victims who died in the period from January 2000 to March 2001 in Slovenia, there were 253 men and 56 women with median age at death of 57.1 and 57.7, respectively. On average, each of them had 2.8 risk factors for ischemic heart disease, and the estimated relative risk of dying during 1 hour after coffee consumption was 1.73 (95% confidence interval [CI]=1.13-2.65), and within 2 hours after alcohol consumption 3.00 (95%CI=1.61-5.68). Within both coffee drinking and alcohol consuming groups, the relative risk was different among persons with different life style habits. It ranged from 1.50 for the coffee drinkers who had been receiving medication due to risk factors of heart diseases, to 2.63 for former alcohol drinkers. Among alcohol consumers it varied from 2.66 among those who were performing less than 104 hours of physical activity of six metabolic equivalents at least, to 52.15 among those of 90 heart beats or more per minute.


CONCLUSIONS
Our research confirmed the hypothesis that coffee or alcohol consumption is a potential trigger for sudden cardiac death in persons with risk factors for ischemic heart disease.
Selb Semerl
Jozica
J
Institute of Public Health of the Republic Slovenia, Trubarjeva cesta 2, 1000 Ljubljana, Slovenia. Jozica.Selb@IVZ-RS.SI
Selb
Kristina
K
D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D003069:Coffee / Q000009:adverse effects*; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015985:Precipitating Factors; D012306:Risk; D017524:Slovenia / Q000453:epidemiology
D003069:Coffee