Short-term Effects of High-Dose Caffeine on Cardiac Arrhythmias in Patients With Heart Failure: A Randomized Clinical Trial
Zuchinali P, Souza GC, Pimentel M, Chemello D, Zimerman A, Giaretta V, Salamoni J, Fracasso B, Zimerman LI, Rohde LE
JAMA internal medicine · 30 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
Según 1 financiador declarado.
Publicación
- Publicado
- 2016-10-17 · JAMA Intern Med · vol. 176 · número 12 · pág. 1752
- Editorial
- American Medical Association
- Citado
- 43 citas · más que el 91% de estudios similares · 3.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 36 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Coffee research and impacts · Cardiac electrophysiology and arrhythmias · Cardiac Health and Mental Health
- Palabras clave
- heart failure, left ventricular systolic dysfunction, ventricular arrhythmias, supraventricular arrhythmias, drug-induced arrhythmia, premature ventricular contractions, exercise testing, caffeine ingestion, implantable cardioverter-defibrillator, decaffeinated coffee, peak oxygen uptake, heart rate response to exercise
- MeSH
- humans, atrial premature complexes, ventricular premature complexes, ventricular dysfunction, left, caffeine, central nervous system stimulants, stroke volume, electrocardiography, exercise test, cross-over studies, double-blind method, oxygen consumption, blood pressure, systole, dose-response relationship, drug, middle aged, female, male, heart failure
10 autores
- Priccila Zuchinali🇧🇷Universidade Federal do Rio Grande do Sul
- Gabriela Corrêa Souza🇧🇷Universidade Federal do Rio Grande do Sul
- Maurício Pimentel🇧🇷Hospital de Clínicas de Porto Alegre
- Diego Chemello🇧🇷Universidade Federal de Santa Maria
- André Zimerman🇧🇷Universidade Federal do Rio Grande do Sul
- Vanessa Giaretta🇧🇷Universidade Federal do Rio Grande do Sul
- Joyce Y. Y. Salamoni🇧🇷Hospital de Clínicas de Porto Alegre
- Bianca de Moraes Fracasso🇧🇷Universidade Federal do Rio Grande do Sul
- Leandro Ioschpe Zimerman🇧🇷Universidade Federal do Rio Grande do Sul; Hospital de Clínicas de Porto Alegre
- Luís Eduardo Paim Rohde🇧🇷 · autor de correspondenciaUniversidade Federal do Rio Grande do Sul; Hospital de Clínicas de Porto Alegre
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias.
Objective
To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test.
Design, setting, and participants
Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital. The trial included patients with chronic heart failure with moderate-to-severe systolic dysfunction (left ventricular ejection fraction <45%) and New York Heart Association functional class I to III between March 5, 2013, and October 2, 2015.
Interventions
Caffeine (100 mg) or lactose capsules, in addition to 5 doses of 100 mL decaffeinated coffee at 1-hour intervals, for a total of 500 mg of caffeine or placebo during a 5-hour protocol. After a 1-week washout period, the protocol was repeated.
Main outcomes and measures
Number and percentage of ventricular and supraventricular premature beats assessed by continuous electrocardiographic monitoring.
Results
We enrolled 51 patients (37 [74%] male; mean [SD] age, 60.6 [10.9] years) with predominantly moderate-to-severe left ventricular systolic dysfunction (mean [SD] left ventricular ejection fraction, 29% [7%]); 31 [61%] had an implantable cardioverter-defibrillator device. No significant differences between the caffeine and placebo groups were observed in the number of ventricular (185 vs 239 beats, respectively; P = .47) and supraventricular premature beats (6 vs 6 beats, respectively; P = .44), as well as in couplets, bigeminal cycles, or nonsustained tachycardia during continuous electrocardiographic monitoring. Exercise test-derived variables, such as ventricular and supraventricular premature beats, duration of exercise, estimated peak oxygen consumption, and heart rate, were not influenced by caffeine ingestion. We observed no increases in ventricular premature beats (91 vs 223 vs 207 beats, respectively) in patients with higher levels of plasma caffeine concentration compared with lower plasma levels (P = .91) or with the placebo group (P = .74).
Conclusions and relevance
Acute ingestion of high doses of caffeine did not induce arrhythmias in patients with systolic heart failure and at high risk for ventricular arrhythmias.
Trial registration
clinicaltrials.gov Identifier: NCT02045992.
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