Background

Physical exertion and caffeine consumption are associated with acute myocardial infarction (MI). However, physical exertion and caffeine consumption have not been examined as immediate triggers of MI in low and middle-income countries.

Objective

Using a self-matched case-crossover design, we examined the acute risk of MI in the hour following episodes of physical exertion, caffeinated coffee, and tea consumption among MI survivors in Thailand.

Methods

A total of 506 Thai participants (women = 191, men = 315) were interviewed between 2014 and 2017 after sustaining an acute MI. We compared each subject’s exposure to physical exertion and consumption of caffeine- containing beverages in the hour preceding the onset of MI with the subject’s expected usual frequency in the prior year to calculate relative risks (RRs) and 95% confidence intervals (95%CIs).

Results

Of the 506 participants, 47 (9.3%) engaged in moderate or heavy physical exertion, 6 (1.2%) consumed tea, and 21 (4.2%) consumed coffee within the hour before MI. The relative risk of MI after moderate or heavy physical exertion was 3.0 (95% CI 2.2–4.2) compared to periods of no exertion, with a higher risk among more sedentary participants compared to active participants. Compared to times with no caffeinated beverage consumption, there was a higher risk of MI in the hour following consumption of caffeinated tea (RR = 3.7; 95%CI: 1.5–9.3) and coffee (RR = 2.3; 95%CI: 1.4–3.6).

Conclusion

Physical exertion, coffee and tea consumption were associated with a higher risk of MI in the subsequent hour compared to times when the participants were sedentary or did not consume caffeinated beverages. Our study identifies high-risk populations for targeted screening and intervention to prevent acute MI.

中文翻译：

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体力活动，饮茶和咖啡后心肌梗塞的即时风险：泰国的病例交叉研究

背景

体力消耗和咖啡因消耗与急性心肌梗塞（MI）有关。但是，在低收入和中等收入国家，体力消耗和咖啡因的摄入并未被视为引发心肌梗死的直接诱因。

客观的

使用自我匹配的病例交叉设计，我们检查了泰国MI幸存者的体力消耗，含咖啡因的咖啡和饮茶后一小时内发生MI的急性风险。

方法

在维持急性心肌梗死后的2014年至2017年之间，总共对506名泰国参与者（女性= 191，男性= 315）进行了访谈。我们将每个受试者在MI发作前一小时的体力消耗和含咖啡因饮料的摄入量与该受试者上一年的预期常规频率进行比较，以计算相对风险（RRs）和95％置信区间（95％CIs） 。

结果

在506名参与者中，有47名（9.3％）从事中度或重度运动，在MI前一小时内喝了6杯（1.2％）的茶，以及21杯（4.2％）的咖啡。与没有运动的时期相比，中度或大量运动后MI的相对风险为3.0（95％CI 2.2–4.2），与久坐的参与者相比，久坐的参与者的MI风险更高。与不饮用含咖啡因饮料的时间相比，饮用含咖啡因的茶（RR = 3.7； 95％CI：1.5-9.3）和咖啡（RR = 2.3； 95％CI：1.4- 3.6）。

结论

与参与者久坐或不食用含咖啡因饮料的时间相比，运动，喝咖啡和茶与随后几小时的MI风险更高。我们的研究确定了高危人群，以进行有针对性的筛查和干预，以预防急性心肌梗死。