Abstract
BACKGROUND: Several published studies have examined the association of coffee consumption with atrial fibrillation (AF) risk, but their findings are still controversial. Therefore, we performed a systematic review and dose-response meta-analysis of prospective studies to determine the relationship between coffee consumption and the risk of incident AF. METHODS: We systematically retrieved the PubMed and Embase databases until October 2021 for pertinent studies that reported the association of coffee consumption (caffeinated or decaffeinated coffee) with AF risk. A cubic spline random-effects model was used to fit the potential dose-response curve. The effect estimates were expressed as adjusted risk ratios (RRs) and 95% CIs. RESULTS: A total of 10 prospective studies (11 cohorts) involving 30,169 AF events and 723,825 participants were included. In the dose-response analysis, there was a linear inverse association between coffee intake and risk of AF although not statistically significant (P (non-linearity) = 0.25). Compared with participants with no coffee consumption, the RRs (95% CI) of AF risk estimated directly from the dose-response curve were 1.01 (0.98-1.03), 1.00 (0.97-1.04), 0.99 (0.92-1.02), 0.95 (0.89-1.01), 0.94 (0.87-1.01), 0.89 (0.79-1.02), and 0.87 (0.76-1.02) for 1-7 cups of coffee per day, respectively. One cup per day increased in coffee consumption was associated with a 2% reduced risk of AF (RR = 0.98, 95% CI: 0.97-1.00, P = 0.02). CONCLUSIONS: Our evidence from this meta-analysis suggested that coffee consumption had a trend toward reducing the risk of AF in a dose-response manner. Further studies could be conducted to reinforce our findings.