Coffee consumption and mortality after acute myocardial infarction: the Stockholm Heart Epidemiology Program.
BACKGROUND
Cohort studies have suggested little effect of coffee consumption on risk of acute myocardial infarction. The effect of coffee consumption on prognosis after myocardial infarction is uncertain.


METHODS
In a population-based inception cohort study, we followed 1,369 patients hospitalized with a confirmed first acute myocardial infarction between 1992 and 1994 in Stockholm County, Sweden, as part of the Stockholm Heart Epidemiology Program. Participants reported usual coffee consumption over the preceding year with a standardized questionnaire distributed during hospitalization and underwent a health examination 3 months after discharge. Participants were followed for hospitalizations and mortality with national registers through November 2001.


RESULTS
A total of 289 patients died during follow-up. Compared with intake of <1 cup per day, coffee consumption was inversely associated with mortality, with multivariable-adjusted hazard ratios of 0.68 (95% confidence interval [CI] 0.45-1.02) for 1 to <3 cups, 0.56 (95% CI 0.37-0.85) for 3 to <5 cups, 0.52 (95% CI 0.34-0.83) for 5 to <7 cups, and 0.58 (95% CI 0.34-0.98) for > or =7 cups per day (P trend .06). Coffee intake was not associated with hospitalization for congestive heart failure or stroke. Candidate lipid and inflammatory biomarkers did not appear to account for the observed inverse association with mortality.


CONCLUSIONS
Self-reported coffee consumption at the time of hospitalization for myocardial infarction was inversely associated with subsequent postinfarction mortality in this population with broad coffee intake. If confirmed in other settings, identification of relevant mechanisms could lead to an improved prognosis for survivors of acute myocardial infarction.
Mukamal
Kenneth J
KJ
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. kmukamal@bidmc.harvard.edu
Hallqvist
Johan
J
Hammar
Niklas
N
Ljung
Rickard
R
Gémes
Katalin
K
Ahlbom
Anders
A
Ahnve
Staffan
S
Janszky
Imre
I
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D003069:Coffee; D004326:Drinking; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
D003069:Coffee