Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial.

Coffee is the most commonly consumed caffeinated beverage in the US, and a randomized trial assessing caffeinated coffee consumption in patients with atrial fibrillation (AF) has not previously been performed.

在美国，咖啡是最常消费的含咖啡因饮料，而之前尚未进行过评估心房颤动（AF）患者摄入含咖啡因咖啡的随机试验。

Background

To determine the effect of caffeinated coffee consumption compared with abstinence from coffee and caffeine on recurrent AF.

确定饮用含咖啡因咖啡与戒除咖啡及咖啡因对复发性房颤的影响。

DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, open-label, randomized clinical trial enrolling 200 current or previous (within past 5 years) coffee-drinking adults with persistent AF, or atrial flutter with a history of AF, planned for electrical cardioversion from 5 hospitals in the US, Canada, and Australia between November 2021 and December 2024.

设计、环境和参与者：这是一项前瞻性、开放标签的随机临床试验，招募了200名当前或过去5年内有持续性房颤或有房颤病史的房扑患者，计划于2021年11月至2024年12月在美国、加拿大和澳大利亚的5家医院进行电复律。

The date of final follow-up was June 5, 2025.

最终随访日期为2025年6月5日。

intervention

Patients were randomized in a 1:1 ratio to regular caffeinated coffee consumption vs coffee and caffeine abstinence for 6 months.

患者以1:1的比例随机分为两组，一组为常规饮用含咖啡因咖啡，另一组为咖啡和咖啡因戒断，持续6个月。

Patients in the coffee consumption group were encouraged to drink at least 1 cup of caffeinated coffee daily.

鼓励咖啡消费组的患者每天至少喝一杯含咖啡因的咖啡。

Patients in the abstinence group were encouraged to completely abstain from both caffeinated and decaffeinated coffee and other caffeine-containing products.

鼓励戒断组的患者完全戒除含咖啡因和无咖啡因的咖啡以及其他含咖啡因的产品。

main_outcomes_and_measures

The primary end point was clinically detected recurrence of AF or atrial flutter over 6 months.

主要终点是6个月内临床上检测到的房颤或房扑复发。

Results

Two hundred patients (mean [SD] age, 69 [11] years; 71% male) were randomized to caffeinated coffee consumption (n = 100) or coffee abstinence (n = 100).

200名患者（平均[标准差]年龄69[11]岁；71%为男性）被随机分配到含咖啡因咖啡消费组（n=100）或咖啡戒断组（n=100）。

Baseline coffee intake was 7 cups (IQR, 7-18) per week in both groups.

两组基线时的咖啡摄入量均为每周7杯（四分位数间距，7-18杯）。

During follow-up, coffee intake in the consumption and abstinence groups was 7 (IQR, 6-11) and 0 (IQR, 0-2) cups per week, respectively, resulting in a between-group difference of 7 cups (95% CI, 7-7) per week.

随访期间，摄入组和禁饮组的咖啡摄入量分别为每周7杯（四分位数间距，6-11杯）和0杯（四分位数间距，0-2杯），两组间差异为每周7杯（95% 置信区间，7-7杯）。

In the primary analysis, AF or atrial flutter recurrence was less in the coffee consumption (47%) than the coffee abstinence (64%) group, resulting in a 39% lower hazard of recurrence (hazard ratio, 0.61 [95% CI, 0.42-0.89]; P = .01).

在主要分析中，与咖啡戒断组（64%）相比，咖啡消费组的房颤或心房扑动复发率较低（47%），导致复发风险降低了39%（风险比，0.61 [95% 置信区间，0.42-0.89]；P = .01）。

A comparable benefit of coffee consumption was observed with AF recurrence only.

观察到咖啡消费对仅房颤复发有类似的益处。

There was no significant difference in adverse events.

在不良事件方面没有显著差异。

conclusions_and_relevance

In this clinical trial of coffee drinkers after successful cardioversion, allocation to consumption of caffeinated coffee averaging 1 cup a day was associated with less recurrence of AF or atrial flutter compared with abstinence from coffee and caffeinated products.

在这项针对成功复律后的咖啡饮用者的临床试验中，平均每天饮用1杯含咖啡因咖啡的分配与完全不饮用咖啡和含咖啡因产品相比，与房颤或心房扑动的复发率较低有关。

trial_registration

ClinicalTrials.gov Identifier: NCT05121519.

临床试验注册号：NCT05121519。