Transient exposure to coffee as a trigger of a first nonfatal myocardial infarction

Abstract

Coffee is one of the most popular beverages worldwide, with an average consumption of 6.7 million tons per year. Prepared from the seed of the coffee plant Coffea arabica originated in Ethiopia and domesticated in Yemen, this beverage has been part of the diet for the past 5 centuries. Coffee contains many biologically active compounds, including caffeine, diterpenes, and polyphenols, with numerous metabolic properties and diverse health effects. Because of the potential adverse effects of coffee on blood cholesterol, homocysteine, and hypertension, the effects of coffee intake on heart disease have been extensively studied for decades. Findings are still controversial, with most case–control studies showing increased heart disease risk for heavy drinkers and cohort studies showing both negative and positive results. Some authors have suggested that this discrepancy is the result of a more acute effect of coffee on the risk of myocardial infarction that could be better assessed using a case–control design. More recent studies have observed a J-shaped association between coffee drinking and heart disease, which suggests that people with light or occasional intake could be at higher myocardial infarction risk because coffee may act as a trigger of myocardial infarction. The transient effects of coffee intake on increased blood pressure and sympathetic tone support this hypothesis. It has also been suggested that the disruption of a vulnerable atherosclerotic plaque in response to hemodynamic stress could trigger a myocardial infarction