Moderate coffee drinking may benefit for patients with LVSD

[Pyankov Vasily]

Most of the studies behind these claims, however, are considering the effect of coffee in the primary prevention (or risk) of heart disease; less well explored is the association between coffee and recurring disease in those who have already experienced an acute coronary event such as a heart attack.

Now, a report presented in Prague at EuroPRevent 2010, the year's principal event for all those engaged in the prevention of cardiovascular diseases, suggests that moderate coffee consumption after an acute coronary event substantially decreases the likelihood of developing left ventricular systolic dysfunction (LVSD), a condition in which the heart's ability to pump blood is reduced by at least 40% and which is a common precursor of heart failure. However, this beneficial effect was only apparent if the patient's blood pressure was in the normal range. The extent of any LVSD is usually measured as a percentage "ejection fraction".

The findings emerged from a study of 374 patients who had all had an acute coronary event - 144 male and 50 female patients who developed LVSD with an ejection fraction of 40% or less, and 129 male and 51 female patients without LVSD (an ejection fraction of 50% or more). The investigators, from Harokopio University and the Hippokration Hospital in Athens, Greece, recorded detailed information about lifestyle characteristics (physical activity, smoking) and nutritional habits, including coffee consumption. The study that was performed under the supervision of Professor Christodoulos Stefanadis and Dr Christina Chrysohoou.

Results showed that in those patients without raised blood pressure moderate coffee consumption of one or two cups a day was associated with an 88% lower likelihood of developing LVSD, and consumption of more than three cups with 90% lower than in those who did not drink coffee. However, this protective effect was not seen in those patients who also had high blood pressure, where the consumption of three or more cups a day was associated with 4.5-fold higher likelihood of developing LVSD.

The investigators note that the effect of coffee on the risk of developing LVSD following an acute coronary event thus depends on blood pressure levels - and may therefore be associated with different outcomes.

Commenting on the results, investigator Christina-Maria Kastorini said: "Coffee contains several biologically active compounds, which may have either beneficial or harmful effects on the cardiovascular system. Coffee is a rich dietary source of chlorogenic acid and antioxidant compounds, and may exert a protective effect against the development of LVSD in normotensive patients. However, in hypertensive patients coffee has a negative influence on blood pressure levels and the beneficial effect of these compounds may not be strong enough."

Коллеги, а что Вы советуете своим пациентам по поводу кофе?