American Heart Association

American Heart Association

Source:

Marcus GM, et al. LBS.03. Prevention to Intervention in Atrial Arrythmias. Presented at: American Heart Association Scientific Sessions; Nov. 13-15, 2021 (virtual meeting).

Disclosures: Marcus reports receiving research grants from Baylis, Eight Sleep, Medtronic, NIH and the Tobacco-Related Disease Research Program, consultant fees from InCarda Therapeutics and Johnson & Johnson and holds an equity stake as a co-founder of InCarda Therapeutics.
November 14, 2021
2 min read
Save

No increase in atrial arrhythmias, more activity, less sleep with coffee consumption

Source:

Marcus GM, et al. LBS.03. Prevention to Intervention in Atrial Arrythmias. Presented at: American Heart Association Scientific Sessions; Nov. 13-15, 2021 (virtual meeting).

Disclosures: Marcus reports receiving research grants from Baylis, Eight Sleep, Medtronic, NIH and the Tobacco-Related Disease Research Program, consultant fees from InCarda Therapeutics and Johnson & Johnson and holds an equity stake as a co-founder of InCarda Therapeutics.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Healthy adults experienced no increase in atrial arrythmias and less supraventricular tachycardia on days they consumed vs. abstained from caffeinated coffee as well as an increase in wearable-measured physical activity in the CRAVE study.

Results presented at the American Heart Association Scientific Sessions also revealed a 54% increase in premature ventricular contractions with coffee consumption; those who metabolized caffeine more quickly experienced a heightened response to premature ventricular contractions with coffee exposure.

Cup of Coffee
Source: Adobe Stock
Gregory M. Marcus

“Overall, the acute yet everyday physiological effects of coffee are complex,” Gregory M. Marcus, MD, MAS, associate chief of cardiology for research and endowed professor of atrial fibrillation research at the University of California, San Francisco, said during a press conference at the American Heart Association Scientific Sessions. “These data add to the growing evidence that those with supraventricular tachycardia or AF or those at risk for those diseases should not necessarily avoid coffee. However, those prone to ventricular arrythmias may benefit from coffee abstinence, but genetic differences influence risk.”

Device-measured responses to coffee

Most coffee-related research has been observational and prone to confounding, with examined long-term effects less relevant to immediate consequences, Marcus said.

The researchers sought to capture the real-time physiologic consequences of coffee consumption in healthy adults using multiple wearable devices.

For CRAVE, 100 healthy volunteers (mean age, 38 years; 51% women; 48% white) were fitted with a continuously recording ECG device (Zio Patch, iRhythm), a wrist-worn Fitbit to measure step counts and sleep, and a continuous glucose monitor (Dexcom). Participants also downloaded a smartphone app for collection of geolocation data (Eureka, UCSF); participant DNA was genotyped for caffeine metabolism-related single nucleotide polymorphisms.

Researchers randomly assigned volunteers to consume or avoid coffee every day for 14 days, communicated via daily texts and reminders.

To measure adherence, participants pressed a button via the Zio patch to timestamp every coffee drink and completed daily surveys recounting coffee consumed the previous day. All date-stamped receipts with coffee purchases were reimbursed. Visits to coffee shops were tracked via geofencing.

Adherence assessments revealed compliance with coffee assignments by every metric employed, Marcus said (P < .01 for all). In the intention-to-treat analyses, random assignment to consume coffee was associated with a 54% increase in premature ventricular contractions (95% CI, 19-200; P = .001), 1,058 additional Fitbit-measured steps per day (95% CI, 441-1675; P = .001) and 36 fewer minutes of Fitbit-measured sleep per night (95% CI, 22-50; P < .001). There were no between-group differences in CGM-measured glucose.

Discussing the findings, Marcus acknowledged that enrolling only regular coffee drinkers could bias the findings.

“Individuals perhaps most prone to coffee-induced problems, such insomnia, palpitations or arrythmias that occur with coffee, may have been excluded,” Marcus said. “If anything, we would think that that would lead to us underestimating heart effects, rather than explaining any false positives.”

‘Innovative but small’ study

Elaine Hylek, MD, MPH, professor of medicine at Boston University School of Medicine and member of the AHA’s Committee on Scientific Sessions Programming, said CRAVE was “an innovative but small study,” calling the findings on atrial arrythmias “somewhat reassuring.”

Hylek said, “if anything, it seems individuals were increasing their physical activity; hopefully that would translate into better CV health. Hopefully, for healthy individuals, we do not have to be too worried about the finding of the [premature ventricular contractions]. For [measured] sleep, it would be nice to know if that was fitful sleep. Were these individuals feeling rested the next day?”

Hylek said the clinical relevance and meaning of a person with a brief episode of AF is still an understudied area.

“We can’t necessarily extrapolate any findings to the persistent and permanent AF group,” Hylek said.