Coffee, also known as java, joe, mud, the elixir of life, and so many other terms, is one of the most popular drinks worldwide. A whopping 66% of people drink coffee daily in the United States alone. Due to the ubiquitous consumption of coffee, there is much interest in exploring its beneficial and detrimental health effects. Studies have demonstrated coffee's beneficial effects on common cardiovascular diseases such as heart disease and heart failure. However, the impact of coffee consumption on certain cardiac arrhythmias such as atrial fibrillation (AF) is poorly understood. Considering AF is the most common cardiac arrhythmia, with a prevalence expected to increase in the coming decades, exploring the relationship between coffee and AF is particularly interesting. Is this outrageously popular 'elixir of life' good or bad when it comes to AF?
In July 2022, the results of a dose-response meta-analysis exploring the relationship between coffee consumption and the risk of AF was published. The analysis included ten moderate-to-high quality prospective studies of nearly 1 million participants, most of which had more than ten years of follow-up. Pooled results demonstrated that per cup/day increase in coffee consumption was significantly associated with a decreased risk of AF in healthy participants (P = 0.02). However, this relationship was also observed when factors such as age, sex, alcohol intake, body mass index, smoking status, and diabetes were accounted for. In addition, coffee intake was not associated with an increased risk of AF.
Importantly, studies assessing only the relationship between caffeine and AF were excluded. The pooled analysis included both caffeinated and decaffeinated coffee. Although caffeine is the most studied component of coffee, it is important to note that coffee contains a variety of biologically active molecules such as chlorogenic acids, cafestol, trigonelline, and others which may vary in concentration depending on brewing methods. Therefore, this analysis specifically explores the effect of coffee on AF and not caffeine. AF risk may be affected differently by caffeinated and decaffeinated coffee, and future studies are needed to explore this relationship further. Based on the current evidence, coffee consumption does not appear to trigger AF development and may reduce the risk of AF. This robust evidence is good news for coffee drinkers.