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Coffee, CYP1A2 Genotype, and Risk of Myocardial Infarction
Open accessAbstract
CONTEXT: The association between coffee intake and risk of myocardial infarction (MI) remains controversial. Coffee is a major source of caffeine, which is metabolized by the polymorphic cytochrome P450 1A2 (CYP1A2) enzyme. Individuals who are homozygous for the CYP1A2*1A allele are "rapid" caffeine metabolizers, whereas carriers of the variant CYP1A2*1F are "slow" caffeine metabolizers. OBJECTIVE: To determine whether CYP1A2 genotype modifies the association between coffee consumption and risk of acute nonfatal MI. DESIGN, SETTING, AND PARTICIPANTS: Cases (n = 2014) with a first acute nonfatal MI and population-based controls (n = 2014) living in Costa Rica between 1994 and 2004, matched for age, sex, and area of residence, were genotyped by restriction fragment-length polymorphism polymerase chain reaction. A food frequency questionnaire was used to assess the intake of caffeinated coffee. MAIN OUTCOME MEASURE: Relative risk of nonfatal MI associated with coffee intake, calculated using unconditional logistic regression. RESULTS: Fifty-five percent of cases (n = 1114) and 54% of controls (n = 1082) were carriers of the slow *1F allele. For carriers of the slow *1F allele, the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of nonfatal MI associated with consuming less than 1, 1, 2 to 3, and 4 or more cups of coffee per day were 1.00 (reference), 0.99 (0.69-1.44), 1.36 (1.01-1.83), and 1.64 (1.14-2.34), respectively. Corresponding ORs (95% CIs) for individuals with the rapid *1A/*1A genotype were 1.00, 0.75 (0.51-1.12), 0.78 (0.56-1.09), and 0.99 (0.66-1.48) (P = .04 for gene x coffee interaction). For individuals younger than the median age of 59 years, the ORs (95% CIs) associated with consuming less than 1, 1, 2 to 3, or 4 or more cups of coffee per day were 1.00, 1.24 (0.71-2.18), 1.67 (1.08-2.60), and 2.33 (1.39-3.89), respectively, among carriers of the *1F allele. The corresponding ORs (95% CIs) for those with the *1A/*1A genotype were 1.00, 0.48 (0.26-0.87), 0.57 (0.35-0.95), and 0.83 (0.46-1.51). CONCLUSION: Intake of coffee was associated with an increased risk of nonfatal MI only among individuals with slow caffeine metabolism, suggesting that caffeine plays a role in this association.
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“The Panel notes that, although this case-control study suggests that polymorphisms of the CYP1A2 gene may affect the risk of MI in relation to caffeine consumption, which may be further affected by polymorphisms of the serotonin receptor gene HTR2A, the results have not yet been replicated and the hypothesis has not been tested in prospective cohort studies.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Cornelis et al., 2006
In the citing paper
“In total, 55 % of cases (n = 1 114) and 54 % of controls (n = 1 082) were carriers of the slow *1F allele, for which the multivariate-adjusted odds ratios (ORs) and 95 % CIs for non-fatal MI associated with the consumption of less than one, one, two to three and four or more cups of coffee per day were 1.00 (reference), 0.99 (0.69-1.44), 1.36 (1.01-1.83)and 1.64 (1.14-2.34),respectively.Cor”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Cornelis et al., 2006
In the citing paper
“A study by Cornelis MC et al.47 showed that CYP1A2 genotype was an effect modifier between coffee consumption and risk of myocardial infarction: coffee consumption was related to higher risk of myocardial infarction for the slow caffeine metabolizer, and was not related to myocardial infarction for the fast caffeine metabolizer.”
From Long-Term Coffee Consumption and Risk of Cardiovascular Disease: A Systematic Review and a Dose–Response Meta-Analysis of Prospective Cohort Studies (2014) · cites this paper as [47]
In the citing paper
“However, this analysis was based on a case-control study conducted in Costa Rico and the results have not been replicated in prospective cohort studies yet.”
From Long-Term Coffee Consumption and Risk of Cardiovascular Disease: A Systematic Review and a Dose–Response Meta-Analysis of Prospective Cohort Studies (2014) · cites this paper as [47]
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Sex Related Differences in the Complex Relationship between Coffee, Caffeine and Atrial Fibrillation
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Genetic polymorphisms of cytochrome P450-1A2 (CYP1A2) among Emiratis
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“Some evidence suggest that higher CA intakes increases the risk of insulin resistance [10], high blood pressure [11], and heart attacks [12] in intermediate and slow but not rapid caffeine metabolizers [8] with fast metabolizer seeing greater improvements in athletic performance [13,14] and reduced appetite [15,16].”
BackgroundEffects of Some Common Food Constituents on Cardiovascular Disease
Yang, Y., Chan, S. W., Hu, M., Walden, R., & Tomlinson, B. (2011) · ISRN Cardiology · doi:10.5402/2011/397136 · Cited by 28
“A study of the association between coffee consumption and risk of acute nonfatal MI found that the polymorphism in the cytochrome P450 1A2 (CYP1A2) enzyme resulting in the variant CYP1A2∗1F with “slow” caffeine metabolism modified the association so that increased intake of coffee was only associated with an increased…”
BackgroundAcute effects of coffee on skin blood flow and microvascular function
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“The rapid metabolizers of caffeinated coffee IA/IA allele have average BP reduction of 10/7 mm Hg and reduce risk of MI by 17%–52% (164).”
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“11 Therefore, the evidence shows that the A allele of the CYP1A2 genotype may be more responsive than the C allele is to caffeine ingestion.”
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“Likewise, an increased risk of hypertension and CVD was observed with moderate and heavy coffee drinkers which was associated a genetic variation in the cytochrome P450 family 1 subfamily A member 2 (CYP1A2) gene [33, 34].”
BackgroundThe immediate and short-term chemosensory impacts of coffee and caffeine on cardiovascular activity
McMullen, M. K., Whitehouse, J. M., Shine, G., Whitton, P. A., & Towell, A. (2011) · Food & Function · doi:10.1039/c1fo10102a · Cited by 22
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“In addition, the CYP1A2∗1F polymorphism raised risk of coffee intake on myocardial infarction as an example of ‘gene and environmental interaction’ studies (51).”
BackgroundPolyphenols and Cholesterol Efflux
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“The non-significant association between coffee drinking and rs762551 genotype observed in the current study is in concordance with previous reports among Costa Ricans [28] and Italians [29].”
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“Furthermore, apart from caffeine habituation, subgroup analyses with regard to specific genetic polymorphisms of caffeine metabolism (Cornelis et al. 2006) or, even more importantly, to chlorogenic acid bioavailability affected by habitual coffee consumption could potentially identify subjects in…”
Effect of Caffeine on Endurance Performance in Athletes May Depend on HTR2A and CYP1A2 Genotypes
Guest, N. S., Corey, P., Tyrrell, P. N., & El‐Sohemy, A. (2020) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000003665 · Cited by 19
“(4,8,40,41,52) with increasing caffeinated coffee consumption,”
ResultCoffee and cardiovascular disease
Dewland, T. A., van Dam, R. M., & Marcus, G. M. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf421 · Cited by 18
Coffee: A Selected Overview of Beneficial or Harmful Effects on the Cardiovascular System?
Whayne, T. F. (2014) · Current Vascular Pharmacology · doi:10.2174/1570161112666141002121429 · Cited by 18
“studied whether a specific CYP1A2 genotype changes the risk for acute myocardial infarction (MI).[10] These authors studied 2,014 cases of first acute nonfatal MI versus 2,014 controls, with both groups living in Costa Rica between 1994 and 2004, that were matched for age (median age 59), sex, and area of residence.”
BackgroundInfluentialQiao, J., Zhang, M., Wang, T., Huang, S., & Zeng, P. (2021) · Frontiers in Genetics · doi:10.3389/fgene.2021.746677 · Cited by 17
“, 2015), and the intake of coffee was associated with an increased risk of nonfatal myocardial infarction in individuals who metabolized caffeine more slowly (Cornelis et al., 2006).”
BackgroundNutrigenomics in Breast Cancer
Dwivedi, S., Shukla, S., Goel, A., Sharma, P., Khattri, S., & Pant, K. K. (2014) · Springer eBooks · doi:10.1007/978-81-322-0843-3_6 · Cited by 17
“Caffeine is metabolized primarily by the cytochrome P450 1A2 (CYP1A2) enzyme, and a polymorphism in the CYP1A2 gene determines whether individuals are “rapid” caffeine metabolizers (those who are homozygous for the −163 A allele) or “slow” caffeine metabolizers (carriers of the −163 C allele) [105].”
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“We chose this variant based on its previous association with caffeine metabolism and its role in modifying the association between caffeinated coffee and the risk of heart disease [27].”
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“…study found significantly lower coffee consumption in sporadic breast cancer cases with at least one C-allele compared with the A/A genotype (Bågeman et al, 2008) in spite of the fact that coffee consumption is similar across CYP1A2*1F genotypes in the general population (Cornelis et al, 2006).”
ResultVrânceanu, M., Pickering, C., Filip, L. A., Pralea, I.-E., Sundaram, S. K., AlSaleh, A. F. F., Popa, D., & Grimaldi, K. A. (2020) · BMC Nutrition · doi:10.1186/s40795-020-00370-7 · Cited by 16
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“Individual responses to coffee consumption, potentially driven by variations in the bioavailability of key metabolites [70], may be affected by gender [18, 60], age [71], weight or BMI [18, 60], health status [15], genetic polymorphisms [72, 73], smoking [60], physical activity [74], dietary habits, and gut microbiota…”
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“Specifically, we compared treatment effects between participants classified as ‘‘slow’’ ( C/C and C/A genotypes) and ‘‘fast’’ ( A/A genotype) metabolizers 19 to determine if the rate of caffeine metabolism influenced outcomes (Table 1).”
Applying Genomics to Nutrition and Lifestyle Modification
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“A recent case–control study provides evidence that caffeine can increase the risk of CHD depending on the P450 cytochrome genotype((22)).”
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“Some potentially important gene by diet interactions include coffee and the cytochrome P4501A2 gene (CYP1A2) (Cornelis et al., 2006), cruciferous vegetable and the glutathione S-transferase gene (GSTT1) (Cornelis et al.”
BackgroundInfluentialRedox ingredients for oxidative stress prevention: the unexplored potentiality of coffee
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“Moreover, some studies suggest more serious health risks among slow caffeine metabolizers, such as an increased risk of hypertension and acute myocardial infarction with increased coffee consumption (Cornelis et al., 2006; Palatini et al., 2009).”
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Coffee consumption and risk of type 2 diabetes
Palatini, P. (2014) · Diabetologia · doi:10.1007/s00125-014-3425-3 · Cited by 11
“These data suggest that, in participants with the fast CYP1A2 *1A/*1A genotype, the harmful effects of caffeine on glucose metabolism are less marked and are outweighed by the favourable action of polyphenols or other bioactive agents [7, 9, 10].”
InfluentialCaffeine reduces the sensitivity of vasodilator MPI for the detection of myocardial ischaemia: Pro
Reyes, E. (2016) · Journal of Nuclear Cardiology · doi:10.1007/s12350-015-0371-5 · Cited by 11
Miranda, A. M., Goulart, A. C., Benseñor, I. M., Lotufo, P. A., & Marchioni, D. M. L. (2020) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2020.1862069 · Cited by 11
“One study (Cornelis et al. 2006) found that coffee drinking increased the risk of MI only in carriers of the 1 F allele.”
BackgroundCaffeine and rheumatoid arthritis: A complicated relationship
Ingegnoli, F., Cavalli, S., Giudice, L., & Caporali, R. F. (2022) · Autoimmunity Reviews · doi:10.1016/j.autrev.2022.103117 · Cited by 11
The magical smell and taste: Can coffee be good to patients with cardiometabolic disease?
Ribeiro, M. M., Alvarenga, L., Cardozo, L., Kemp, J. A., Lima, L. S., de Almeida, J. S., Leal, V. D. O., Stenvinkel, P., Shiels, P. G., & Mafra, D. (2022) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2022.2106938 · Cited by 14
“The change in this allele directly interferes with caffeine metabolization, and "slow" metabo-lisers may be associated with a greater risk of myocardial infarction and hypertension, indicating a decrease of coffee consumption (Palatini et al. 2009; Cornelis et al. 2006).”
BackgroundTang, L., Yang, L., Chen, W., Li, C., Zeng, Y., Yang, H., Hu, Y., Qu, Y., Song, H., Zeng, X., et al. (2022) · Chinese Medical Journal · doi:10.1097/cm9.0000000000002234 · Cited by 11
“Meanwhile, the genetic polymorphisms affecting caffeine metabolism are also associated with increased risk of several health impairments, including hypertension, impaired fasting glucose, and myocardial infarction.([17-19]) Therefore, it is worth examining whether the effect of coffee on incident CKD is independent of…”
BackgroundCoffee consumption and risk of aortic valve stenosis: A prospective study
Larsson, S. C., Wolk, A., Håkansson, N., & Bäck, M. (2018) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2018.01.016 · Cited by 11
Addiction to Caffeine and Other Xanthines
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Homocysteine Lowering with Folic Acid and B Vitamins in Vascular Disease
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Coffee intake and hypertension in Korean adults: results from KNHANES 2012–2016
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“In a matched case-control study (N=4,028) of subjects living in Costa Rica, an increased risk of myocardial infarction with increasing coffee consumption has been reported among carriers of the CYP1A2 C variant [56].”
BackgroundWierzejska, R. E. (2016) · Polish Journal of Food and Nutrition Sciences · doi:10.1515/pjfns-2015-0048 · Cited by 10
Smoking habits and the risk of non-fatal acute myocardial infarction in Costa Rica
Rossi, M., Negri, E., Vecchia, C. L., & Campos, H. (2011) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/1741826710389381 · Cited by 12
“hypercholesterolemia and current abdominal obesity, and the intakes of alcohol and coffee.(26,27) History of diabetes, hypertension and hypercholesterolemia was self-reported, so adjustment for these covariates may not be optimal.”
BackgroundResultThe metabolic nature of individuality
Dragsted, L. O. (2020) · Nature Food · doi:10.1038/s43016-020-0104-z · Cited by 10
Coffee, Myocardial Infarction, and CYP Nomenclature
Ingelman‐Sundberg, M., Sim, S. C., & Nebert, D. W. (2006) · JAMA · doi:10.1001/jama.296.7.764-b · Cited by 10
Coffee and sleep: Benefits and risks
Davisaraei, Y. B., Nateghi, S., Rashidipour, H., Raise‐Abdullahi, P., & Rashidy‐Pour, A. (2024) · Progress in brain research · doi:10.1016/bs.pbr.2024.06.014 · Cited by 13
Virgili, J., Motitis, P., Julal, G., Mavrommatis, Y., & Pilić, L. (2023) · Nutrition Bulletin · doi:10.1111/nbu.12606 · Cited by 13
Iglesias‐Carres, L., & Neilson, A. P. (2021) · Food & Function · doi:10.1039/d1fo02782d · Cited by 9
Second-Trimester Maternal Serum Paraxanthine, CYP1A2 Activity, and the Risk of Severe Preeclampsia
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Coffee Consumption and Coronary Heart Diseases: A Mini-Review
Shateri, Z., & Djafarian, K. (2016) · Journal of Clinical Nutrition & Dietetics · doi:10.4172/2472-1921.100010 · Cited by 9
Coffee and mental disorders: How caffeine affects anxiety and depression
Meamar, M., Raise‐Abdullahi, P., Rashidy‐Pour, A., & Raeis-Abdollahi, E. (2024) · Progress in brain research · doi:10.1016/bs.pbr.2024.06.015 · Cited by 13
Zheng, J., Chen, H., Yang, Q., Zhou, Z., Yang, C., Huang, J., Tu, Q., Wu, H., Qiu, P., Huang, W., et al. (2024) · Heart Rhythm · doi:10.1016/j.hrthm.2024.11.047 · Cited by 11
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The Role of Xenobiotic Caffeine on Cardiovascular Health: Promises and Challenges
Campagna, R., & Vignini, A. (2025) · Journal of Xenobiotics · doi:10.3390/jox15020051 · Cited by 8
“Cornelis et al. investigated whether the CYP1A2 genotype influences the association between coffee intake and risk of acute nonfatal myocardial infarction [49].”
InfluentialAllele Frequency and Genotype Distribution of 9 SNPs in the Kazakh Population
Romanova, A. A. (2014) · Journal of Pharmacogenomics & Pharmacoproteomics · doi:10.4172/2153-0645.1000129 · Cited by 8
“*Different sources with a population sample of more than 100 people (including HapMap data) [3-8,10-12,20-48].”
BackgroundGenetic test for the prescription of diets in support of physical activity.
Naureen, Z., Miggiano, G. A. D., Aquilanti, B., Velluti, V., Matera, G., Gagliardi, L., Zulian, A., Romanelli, R., & Bertelli, M. (2020) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · doi:10.23750/abm.v91i13-s.10584 · Cited by 11
“One of those studies analyzed the involvement of genetic variants in the gene CYP1A2 encoding a caffeine-metabolizing enzyme in CVD (27).”
BackgroundInfluentialLuo, K., Hochalter, J. B., Carmella, S. G., & Hecht, S. S. (2020) · Journal of Chromatography B · doi:10.1016/j.jchromb.2020.122023 · Cited by 8
Sabião, T. D. S., Bressan, J., Pimenta, A. M., Hermsdorff, H. H. M., de Oliveira, F. L. P., Mendonça, R. D. D., Carraro, J. C. C., & de Aguiar, A. S. (2021) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2021.05.025 · Cited by 8
Cytochrome P450 and ischemic heart disease: current concepts and future directions
Rowland, A., & Mangoni, A. A. (2013) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1517/17425255.2014.859675 · Cited by 8
“By contrast, other studies considered a wider range of clinical and demographic confounders [146-148,151,152,157-159,161].”
BackgroundResultPimentel, G. D., Micheletti, T. O., Fernandes, R. C., & Nehlig, A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-816093-0.00024-0 · Cited by 8
Tajima, M. K. O. (2013) · Endocrinology & Metabolic Syndrome · doi:10.4172/2161-1017.1000119 · Cited by 9
“Coffee consumption was associated with an increased risk of myocardial infarction among carriers of the inactive allele (C allele) of CYP1A2*1F in the former study [27].”
BackgroundRuskovska, T., Postolov, F., & Milenković, D. (2024) · Nutrients · doi:10.3390/nu16091362 · Cited by 7
“These studies identified caffeine as a key factor for increased risk only for individuals with slow caffeine metabolism [45] that is associated with the − 163A > C (rs762551) single nucleotide polymorphism of the Cytochrome P450 Family 1 Subfamily A Member 2 ( CYP1A2 ) gene.”
Background
Metadata
- Authors
- Cornelis, M. C., El-Sohemy, A., Kabagambe, E. K., & Campos, H.
- Affiliations
- University of Toronto (CA)
- Harvard University (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2006-03-08
- Volume
- 295
- Issue
- 10
- Pages
- 1135
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1972508135
- Cited by
- 490
- References
- 52
- Citations by year
- 2026: 22 · 2025: 26 · 2024: 26 · 2023: 21 · 2022: 20 · 2021: 21 · 2020: 24 · 2019: 24 · 2018: 30 · 2017: 30 · 2016: 21 · 2015: 22 · 2014: 28 · 2013: 22 · 2012: 24
- FWCI
- 16.50
- Type
- journal article
- Language
- en
- Open access
- green
- jamanetwork.com
- Licence
- other-oa
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Investigative News in Education (Universidad de Costa Rica) (submittedVersion)
- Funders
- Harvard University
- Universidad de Costa Rica
- National Heart, Lung, and Blood Institute (HL 60692, HL 071888, R01HL071888, R01HL060692)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Coffee research and impacts
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Keywords
- coffee consumption, myocardial infarction, caffeine metabolism, gene-environment interaction, cardiovascular risk, Costa Rica, young adults, hormone replacement therapy
- MeSH terms
- Aged, Catchment Area, Health, Coffee, Costa Rica, Female, Genotype, Humans, Male, Middle Aged, Myocardial Infarction, Polymorphism, Restriction Fragment Length, Risk Factors, Logistic Models, Polymerase Chain Reaction, Cytochrome P-450 CYP1A2, Amino Acid Substitution
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