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The impact of coffee in patients with previous myocardial infarction : systematic review and meta-analysis
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Autores
Orientador(es)
Resumo(s)
Objetivo
Avaliar o impacto do consumo de café em doentes com enfarte agudo do miocárdio (EAM) prévio, relativamente à mortalidade global e cardiovascular, bem como outros eventos cardiovasculares major, como acidentes vasculares cerebrais (AVCs), insuficiência cardíaca, EAM recorrente e morte súbita.
Métodos
Foram pesquisados nas plataformas MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection, SciELO Citation Database, Current Contents Connect®, KCI Korean Journal Database, African Index Medicus, e LILACS, estudos longitudinais (estudos de coorte observacionais e ensaios clínicos) que avaliassem o impacto do consumo de café nos doentes com EAM prévio. Realizou-se uma meta-análise usando o modelo de efeitos aleatórios para estimar com 95% CI os HRs combinados, e a heterogeneidade foi avaliada usando a estatística I2. Realizou-se também uma análise da relação dose-resposta.
Resultados
Foram incluídos sete estudos de coorte prospetivos na meta-análise, avaliando 21890 doentes com EAM prévio. Verificou-se que o consumo de café estava associado a um risco diminuído de mortalidade global (HR=0.81; 95% CI 0.65-1.00; I²=50%; 4 estudos) e risco diminuído de mortalidade cardiovascular (HR=0.70; 95% CI 0.57-0.86; I²=0%; 3 estudos). Verificou-se também uma significativa relação inversa de dose-resposta não linear entre o consumo de café e a mortalidade global e cardiovascular. A análise combinada do efeito do consumo de café no EAM recorrente (HR=1.01; 95% CI 0.85-1.19; I²=0%; 4 estudos), AVCs (HR=0.77; 95% CI 0.42 to 1.43; I²=39%; 3 estudos) e eventos cardiovasculares major (HR=0.96; 95% CI 0.86 to 1.07; I²=0%; 2 estudos) não foi significativa.Conclusões
Não se verificou uma associação entre o consumo de café e o aumento do risco de mortalidade global e cardiovascular em doentes com EAM prévio.
Objective To evaluate the impact of coffee consumption in patients with previous myocardial infarction (MI), in relation to all-cause and cardiovascular mortality, as well as other major cardiovascular events (MACE) such as stroke, heart failure, recurrent MI and sudden death. Methods MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection, SciELO Citation Database, Current Contents Connect®, KCI Korean Journal Database, African Index Medicus, and LILACS were searched for longitudinal studies evaluating the impact of coffee consumption in patients with previous myocardial infarction. We performed a random-effects meta-analysis to estimate the pooled hazard ratios (HR) with 95% confidence intervals (CI). The statistical heterogeneity was measured by I². A dose-response analysis was also conducted. Results Seven prospective cohort studies were included in the meta-analysis. Consumption of coffee was associated with lower risk of all-cause mortality (HR=0.81; 95% CI 0.65 to 1.00; I²=50%; 4 studies) and lower risk of cardiovascular mortality (HR=0.70; 95% CI 0.57 to 0.86; I²=0%; 3 studies). A significant non-linear inverse dose-response association was found for coffee consumption and both all-cause mortality and cardiovascular mortality. The effect of coffee consumption in a pooled analysis of recurrent MI (HR=1.01; 95% CI 0.85 to 1.19; I²=0%; 4 studies), stroke (HR=0.77; 95% CI 0.42 to 1.43; I²=39%; 3 studies) and MACE (HR=0.96; 95% CI 0.86 to 1.07; I²=0%; 2 studies) was not significant. Conclusions Consumption of coffee was not associated with an increased risk of all-cause mortality and cardiovascular events in patients with previous myocardial infarction.
Objective To evaluate the impact of coffee consumption in patients with previous myocardial infarction (MI), in relation to all-cause and cardiovascular mortality, as well as other major cardiovascular events (MACE) such as stroke, heart failure, recurrent MI and sudden death. Methods MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection, SciELO Citation Database, Current Contents Connect®, KCI Korean Journal Database, African Index Medicus, and LILACS were searched for longitudinal studies evaluating the impact of coffee consumption in patients with previous myocardial infarction. We performed a random-effects meta-analysis to estimate the pooled hazard ratios (HR) with 95% confidence intervals (CI). The statistical heterogeneity was measured by I². A dose-response analysis was also conducted. Results Seven prospective cohort studies were included in the meta-analysis. Consumption of coffee was associated with lower risk of all-cause mortality (HR=0.81; 95% CI 0.65 to 1.00; I²=50%; 4 studies) and lower risk of cardiovascular mortality (HR=0.70; 95% CI 0.57 to 0.86; I²=0%; 3 studies). A significant non-linear inverse dose-response association was found for coffee consumption and both all-cause mortality and cardiovascular mortality. The effect of coffee consumption in a pooled analysis of recurrent MI (HR=1.01; 95% CI 0.85 to 1.19; I²=0%; 4 studies), stroke (HR=0.77; 95% CI 0.42 to 1.43; I²=39%; 3 studies) and MACE (HR=0.96; 95% CI 0.86 to 1.07; I²=0%; 2 studies) was not significant. Conclusions Consumption of coffee was not associated with an increased risk of all-cause mortality and cardiovascular events in patients with previous myocardial infarction.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Café Enfarte agudo do miocárdio Mortalidade Eventos cardiovasculares Meta-análise