咖啡亚型对心血管疾病、心律失常和死亡率的影响：来自英

StephenW

咖啡亚型对心血管疾病、心律失常和死亡率的影响：来自英国生物银行的长期结果

2022 年 9 月 27 日

结论

脱咖啡因、研磨咖啡和速溶咖啡，特别是每天 2-3  杯，与 CVD 发病率和死亡率的显着降低有关。研磨和速溶但不含咖啡因的咖啡与减少心律失常有关。


总体咖啡摄入量和心血管疾病发生率

在随访期间，43 173 名 (9.6%) 参与者被诊断出心血管疾病。共有 34 677 名 (7.7%) 参与者被诊断出患有冠心病，12 966 名 (2.8%) 患有 CCF，6767 名 (1.5%) 患有中风。与不饮酒者相比，每天最多 5 杯的习惯性咖啡摄入量与发生 CVD 的风险显着降低相关。每天喝 5 杯咖啡的习惯性咖啡摄入量显着降低发生冠心病的风险，每天喝 2-3 杯咖啡的人患冠心病的风险最低（HR 0.89，CI 0.86-0.91，P < 0.0001)。所有级别的咖啡消费与 CCF 和缺血性中风风险的显着降低相关（图 2）。在每天饮用 2-3 杯的人中观察到的风险最低，CCF 的 HR 0.83（CI 0.79-0.87，P < 0.0001），缺血性中风的 HR 0.84（CI 0.78-0.90，P < 0.0001；见补充在线材料，表 S2）。
总体咖啡摄入量和全因/心血管死亡率

长期随访期间共有 27 809 名 (6.2%) 参与者死亡，其中 4402 名 (1.0%) 死于 CV 原因。全因死亡率显着降低与每天喝 5 杯咖啡有关，每天喝 2-3 杯咖啡效果最好（HR 0.86，CI 0.83-0.89，P < 0.0001）。在每天 1-5 杯咖啡饮用者中观察到 CV 死亡率显着降低（最低风险 1 杯/天；HR 0.82，CI 0.74-0.90，P < 0.0001；参见在线补充材料，图 S1）。咖啡摄入量与心源性猝死风险无关（参见在线补充材料，图 S2）。
研磨咖啡

在 82 575 名咖啡粉饮用者中，5872 人 (7.0%) 被诊断出心律失常，主要是 AF/扑动 (3269, 3.9%)； CVD 8670 (10.5%)，CHD 7154 (8.6%)，CCF 1976 (2.3%)，中风1114 (1.3%)。中位随访 12.5 年（IQR 11.7-13.2）时，总死亡率为 5.5%（4511）。每天 1 到 5 杯咖啡粉摄入与任何心律失常的发生率显着降低有关，特别是 AF/扑动（图 3A，在线补充材料，表 S4）。每天 2-5 杯可降低 SVT 和 VT/VF 风险（图 3B）。每天饮用多达 5 杯咖啡粉与显着降低 CVD、CHD 和 CCF 的风险相关（图 4）。所有级别的磨碎咖啡消费都显着降低了全因死亡和心血管死亡的风险（图 5）。全因死亡率最低，为 2-3 杯/天（HR 0.73，CI 0.69-0.78，P < 0.0001），而 CV 死亡率最低，为 4-5 杯/天（HR 0.65，CI 0.51-0.83，P < 0.0001；见在线补充材料，表 S5）。
速溶咖啡

在 198 062 名速溶咖啡饮用者中，16 696 人 (8.4%) 被诊断为心律失常，主要是 AF/扑动 (9273, 4.7%)，29 751 人 (15.0%) 患有心律失常，25 051 人 (12.6%) 患有心律失常， CCF 7029 (3.5%)，中风 3707 (1.8%)。在中位随访 12.5 年（IQR 11.7-13.2）时，总死亡率为 7.7%（15 365）。一般而言，在速溶咖啡摄入量与各种 CVD 终点之间观察到 U 型关系。特别是，每天 2-3 杯速溶咖啡与任何心律失常的风险最低相关（HR 0.88，CI 0.85-0.92，P < 0.001），CVD（HR 0.91，CI 0.88-0.94，P < 0.0001）， CHD（HR 0.91，CI 0.88–0.94，P < 0.0001），中风（HR 0.83，CI 0.76–0.90，P < 0.0001）和全因死亡率（HR 0.89，CI 0.86–0.93，P < 0.0001；图 4和 5）。在心律失常亚型中，AF/扑动（HR 0.85，CI 0.79-0.91，P < 0.0001；图 3A）和 SVT（HR 0.75，CI 0.63-0.88，P = 0.0005）的事件风险最低，为 4-5 杯/天; 图 3B，在线补充材料，表 S4）。
无咖啡因的咖啡

在 68 416 名不含咖啡因的咖啡饮用者中，6737 人（9.8%）被诊断为心律失常（3889 人患有房颤/扑动），9904 人被诊断为心血管疾病（14.5%），2263 人被诊断为 CCF（3.3%），1224 人被诊断为缺血性中风（1.7 %）。在中位随访 12.5 年（IQR 11.7-13.2）时，总死亡率为 10.9%（7434）。 CVD、CHD 和 CCF 的风险降低，尤其是每天摄入 2-3 杯，风险比为 0.94（CI 0.90-0.99，P = 0.0093）、0.94（CI 0.89-0.99，P = 0.0127） , 和 0.86 (CI 0.79–0.94, P = 0.0004)，分别（图形摘要）。无咖啡因咖啡摄入量与全因死亡率之间存在 U 型关系，每天 2-3 杯咖啡的风险最低（HR 0.86，CI 0.80-0.91，P < 0.0001）。每天饮用 1 至 3 杯咖啡也可降低心血管死亡率（最低风险 1 杯/天：H

StephenW

The impact of coffee subtypes on incident cardiovascular disease, arrhythmias, and mortality: long-term outcomes from the UK Biobank

Sept 27 2022

Conclusion

Decaffeinated, ground, and instant coffee, particularly at 2–3 cups/day, were associated with significant reductions in incident CVD and mortality. Ground and instant but not decaffeinated coffee was associated with reduced arrhythmia.


Overall coffee intake and incident cardiovascular disease

Cardiovascular disease was diagnosed in 43 173 (9.6%) participants during follow-up. A total of 34 677 (7.7%) participants were diagnosed with incident CHD, 12 966 (2.8%) with incident CCF, and 6767 (1.5%) with incident stroke. Habitual coffee intake of up to 5 cups/day was associated with significant reductions in the risk of incident CVD, when compared with non-drinkers. Significant reductions in the risk of incident CHD were associated with habitual coffee intake of up to 5 cups/day, with the lowest risk for CHD observed in those who consumed 2–3 cups/day (HR 0.89, CI 0.86–0.91, P < 0.0001). Coffee consumption at all levels was associated with significant reduction in the risk of CCF and ischaemic stroke (Figure 2). The lowest risks were observed in those who consumed 2–3 cups/day, with HR 0.83 for CCF (CI 0.79–0.87, P < 0.0001), and HR 0.84 for ischaemic stroke (CI 0.78–0.90, P < 0.0001; see Supplementary material online, Table S2).
Overall coffee intake and all-cause/cardiovascular mortality

A total of 27 809 (6.2%) participants died during long-term follow-up, including 4402 (1.0%) from CV causes. A significant reduction in all-cause mortality was associated with coffee consumption up to 5 cups/day, with the greatest effect seen with 2–3 cups/day (HR 0.86, CI 0.83–0.89, P < 0.0001). A significant reduction in CV mortality was observed in coffee drinkers of 1–5 cups/day (lowest risk 1 cup/day; HR 0.82, CI 0.74–0.90, P < 0.0001; see Supplementary material online, Figure S1). Coffee intake was not associated with a risk of sudden cardiac death (see Supplementary material online, Figure S2).
Ground coffee

Of the 82 575 ground coffee drinkers, an arrhythmia was diagnosed in 5872 (7.0%) which was predominantly AF/flutter (3269, 3.9%); CVD in 8670 (10.5%), CHD in 7154 (8.6%), CCF in 1976 (2.3%), and stroke in 1114 (1.3%). Total mortality was 5.5% (4511) at a median follow-up of 12.5 years (IQR 11.7–13.2). Ground coffee intake between 1 and 5 cups/day was associated with a significant reduction in the incidence of any arrhythmia, and specifically AF/flutter (Figure 3A, Supplementary material online, Table S4). A reduction in SVT and VT/VF risk was seen with 2–5 cups/day (Figure 3B). Ground coffee consumption at up to 5 cups/day was associated with a significant reduction in the risk of CVD, CHD, and CCF (Figure 4). Ground coffee consumption at all levels significantly reduced the risk of all-cause and CV mortality (Figure 5). All-cause mortality was lowest at 2–3 cups/day (HR 0.73, CI 0.69–0.78, P < 0.0001), whereas CV mortality was lowest at 4–5 cups/day (HR 0.65, CI 0.51–0.83, P < 0.0001; see Supplementary material online, Table S5).
Instant coffee

Of the 198 062 instant coffee drinkers, an arrhythmia was diagnosed in 16 696 (8.4%) which was predominantly AF/flutter (9273, 4.7%), CVD in 29 751 (15.0%), CHD in 25 051 (12.6%), CCF in 7029 (3.5%), and stroke in 3707 (1.8%). Total mortality was 7.7% (15 365) at a median follow-up of 12.5 years (IQR 11.7–13.2). In general, a U-shaped relationship was observed between instant coffee intake and the various CVD endpoints. In particular, 2–3 cups of instant coffee/day was associated with the lowest risk for any arrhythmia (HR 0.88, CI 0.85–0.92, P < 0.001), CVD (HR 0.91, CI 0.88–0.94, P < 0.0001), CHD (HR 0.91, CI 0.88–0.94, P < 0.0001), stroke (HR 0.83, CI 0.76–0.90, P < 0.0001), and all-cause mortality (HR 0.89, CI 0.86–0.93, P < 0.0001; Figures 4 and 5). Amongst the arrhythmia subtypes incident risks were lowest at 4–5 cups/day for AF/flutter (HR 0.85, CI 0.79–0.91, P < 0.0001; Figure 3A), and SVT (HR 0.75, CI 0.63–0.88, P = 0.0005; Figure 3B, Supplementary material online, Table S4).
Decaffeinated coffee

Of the 68 416 decaffeinated coffee drinkers, an arrhythmia was diagnosed in 6737 (9.8%) with (AF/flutter in 3889), CVD in 9904 (14.5%), CCF in 2263 (3.3%), and ischaemic stroke in 1224 (1.7%). Total mortality was 10.9% (7434) at a median follow-up of 12.5 years (IQR 11.7–13.2). The risk of CVD, CHD, and CCF were reduced particularly with an intake of 2–3 cups/day, with hazard ratios of 0.94 (CI 0.90–0.99, P = 0.0093), 0.94 (CI 0.89–0.99, P = 0.0127), and 0.86 (CI 0.79–0.94, P = 0.0004), respectively (Graphical Abstract). A U-shaped relationship was demonstrated between decaffeinated coffee intake and all-cause mortality, with the lowest risk seen with 2–3 cups/day (HR 0.86, CI 0.80–0.91, P < 0.0001). Cardiovascular mortality was also reduced at a coffee intake between 1 and 3 cups/day (lowest risk 1 cup/day: H