The DOI matches its Crossref record; 53 of the 54 references it cites were found in a registry or an index.
Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta‐analysis of observational studies
Abstract
BACKGROUND: Atrial fibrillation (AF) is the most prevalent sustained arrhythmia, and risk factors are well established. Caffeine exposure has been associated with increased risk of AF, but heterogeneous data exist in the literature. OBJECTIVE: To evaluate the association between chronic exposure to caffeine and AF. DESIGN: Systematic review and meta-analysis of observational studies. DATA SOURCES: PubMed, CENTRAL, ISI Web of Knowledge and LILACS to December 2012. Reviews and references of retrieved articles were comprehensively searched. STUDY SELECTION: Two reviewers independently searched for studies and retrieved their characteristics and data estimates. DATA SYNTHESIS: Random-effects meta-analysis was performed, and pooled estimates were expressed as OR and 95% CI. Heterogeneity was assessed with the I(2) test. Subgroup analyses were conducted according to caffeine dose and source (coffee). RESULTS: Seven observational studies evaluating 115 993 individuals were included: six cohorts and one case-control study. Caffeine exposure was not associated with an increased risk of AF (OR 0.92, 95% CI 0.82 to 1.04, I(2)=72%). Pooled results from high-quality studies showed a 13% odds reduction in AF risk with lower heterogeneity (OR 0.87; 95% CI 0.80 to 0.94; I(2)=39%). Low-dose caffeine exposure showed OR 0.85 (95% CI 0.78 to 92, I(2)=0%) without significant differences in other dosage strata. Caffeine exposure based solely on coffee consumption also did not influence AF risk. CONCLUSIONS: Caffeine exposure is not associated with increased AF risk. Low-dose caffeine may have a protective effect.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“There was no significant association between caffeine exposure and AF risk in primary or subgroup analyses, considering age, sex, race, study quality, caffeine from coffee versus caffeine from all sources, caffeine dose or duration of follow-up.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Caldeira et al., 2013
In the citing paper
“The Panel notes that habitual caffeine consumption from all sources up to about 1 000 mg per day was not significantly associated with an increased risk of AF in these two meta-analyses.”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Caldeira et al., 2013
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Meta-analysis of Observational Studies in Epidemiology<SUBTITLE>A Proposal for Reporting</SUBTITLE>
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, F. T. S. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-8-200710160-00010 · Cited by 17,796
Atrial fibrillation as an independent risk factor for stroke: the Framingham study
Wolf, P. A., Abbott, R. D., & Kannel, W. B. (1991) · Stroke · doi:10.1161/01.str.22.8.983 · Cited by 7,388
Impact of Atrial Fibrillation on the Risk of Death: The Framingham Heart Study
Benjamin, E. J., Wolf, P. A., D’Agostino, R. B., Silbershatz, H., Kannel, W. B., & Levy, D. (1998) · Circulation · doi:10.1161/01.cir.98.10.946 · Cited by 4,575
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007) · Preventive Medicine · doi:10.1016/j.ypmed.2007.08.012 · Cited by 2,698
Benjamin, E. J. (1994) · JAMA · doi:10.1001/jama.1994.03510350050036 · Cited by 2,613
Comparison of two methods to detect publication bias in meta-analysis.
Peters, J. L. (2006) · JAMA · doi:10.1001/jama.295.6.676 · Cited by 2,278
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007) · Epidemiology · doi:10.1097/ede.0b013e3181577654 · Cited by 1,991
Chapter 10: Addressing reporting biases
Egger, M., & Moher, D. (2011) · Cited by 977
Coffee Consumption and Risk of Type 2 Diabetes: A Systematic Review
van Dam, R. M., & Hu, F. B. (2005) · JAMA · doi:10.1001/jama.294.1.97 · Cited by 662
Deeks, J. J. (2002) · Statistics in Medicine · doi:10.1002/sim.1188 · Cited by 660
BENEFITS AND POTENTIAL HARM OF LOWERING HIGH BLOOD PRESSURE
Cruickshank, J., Thorp, J. M., & Zacharias, F. J. (1987) · The Lancet · doi:10.1016/s0140-6736(87)90231-5 · Cited by 652
Association of Coffee Drinking with Total and Cause-Specific Mortality
Freedman, N. D., Park, Y., Abnet, C. C., Hollenbeck, A. R., & Sinha, R. R. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1112010 · Cited by 597
Coffee, Decaffeinated Coffee, and Tea Consumption in Relation to Incident Type 2 Diabetes Mellitus
Huxley, R. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.439 · Cited by 476
Farnett, L. (1991) · JAMA · doi:10.1001/jama.265.4.489 · Cited by 417
The Global Burden of Atrial Fibrillation and Stroke
Lip, G. Y. H., Brechin, C. M., & Lane, D. A. (2012) · CHEST Journal · doi:10.1378/chest.11-2888 · Cited by 382
Mesas, A. E., Leon-Muñoz, L. M., Rodriguez-Artalejo, F., & Lopez-Garcia, E. (2011) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.016667 · Cited by 350
Caffeine Content of Specialty Coffees
McCusker, R. R., Goldberger, B. A., & Cone, E. J. (2003) · Journal of Analytical Toxicology · doi:10.1093/jat/27.7.520 · Cited by 306
Wong, W. C., Cheung, C. S., & Hart, G. J. (2008) · Emerging Themes in Epidemiology · doi:10.1186/1742-7622-5-23 · Cited by 257
Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis
Buitrago-Lopez, A., Sanderson, J., Johnson, L., Warnakula, S., Wood, A., Di Angelantonio, E., & Franco, O. H. (2011) · BMJ · doi:10.1136/bmj.d4488 · Cited by 252
Ranheim, T., & Halvorsen, B. L. (2005) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.200400109 · Cited by 251
Caldeira, D., Alarcão, J., Carneiro, A. V., & Costa, J. N. (2012) · BMJ · doi:10.1136/bmj.e4260 · Cited by 247
Self-citationCoffee and Myocardial Infarction
Jick, H., Miettinen, O. S., Neff, R. K., Shapiro, S., Heinonen, O. P., & Slone, D. (1973) · New England Journal of Medicine · doi:10.1056/nejm197307122890203 · Cited by 205
Wu, J.-N., Ho, S. C., Zhou, C., Ling, W.-H., Chen, W.-Q., Wang, C.-L., & Chen, Y.-M. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.06.051 · Cited by 185
Habitual Coffee Consumption and Risk of Heart Failure: A Dose-Response Meta-Analysis
Mostofsky, E., Rice, M. S., Levitan, E. B., & Mittleman, M. A. (2012) · Circulation: Heart Failure · doi:10.1161/circheartfailure.112.967299 · Cited by 185
Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors
Wilhelmsen, L., Rosengren, A., & Lappas, G. (2001) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2001.00902.x · Cited by 184
Effect Measures for Meta‒Analysis of Trials with Binary Outcomes
Deeks, J. J., & Altman, D. G. (2001) · doi:10.1002/9780470693926.ch16 · Cited by 176
Zhang, Z., Hu, G., Caballero, B., Appel, L., & Chen, L. (2011) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.004044 · Cited by 166
A meta‐analysis of coffee, myocardial infarction, and coronary death
Greenland, S. (1993) · Epidemiology · doi:10.1097/00001648-199307000-00013 · Cited by 163
Caffeine and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study
Frost, L., & Vestergaard, P. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.3.578 · Cited by 134
Dietary factors and incident atrial fibrillation: the Framingham Heart Study
Shen, J., Johnson, V. M., SULLIVAN, L. M., Jacques, P. F., Magnani, J. W., Lubitz, S. A., Pandey, S., Levy, D. A., Vasan, R. S., Quatromoni, P. A., et al. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.001305 · Cited by 133
Coffee, caffeine, and coronary heart disease
Cornelis, M. C., & El‐Sohemy, A. (2007) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e3282f05d81 · Cited by 113
Caffeine consumption and incident atrial fibrillation in women
Conen, D., Chiuve, S. E., Everett, B. M., Zhang, S. M., Buring, J. E., & Albert, C. M. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2010.29627 · Cited by 111
Caffeine and Cardiac Arrhythmias
Myers, M. G. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-2-147 · Cited by 101
Acute effects of caffeine on heart rate variability
Sondermeijer, H. P., van Marle, A. G. J., Kamen, P., & Krum, H. (2002) · The American Journal of Cardiology · doi:10.1016/s0002-9149(02)02725-x · Cited by 99
Caffeine and Cardiac Arrhythmias: A Review of the Evidence
Pelchovitz, D. J., & Goldberger, J. J. (2011) · The American Journal of Medicine · doi:10.1016/j.amjmed.2010.10.017 · Cited by 94
Coffee, Caffeine, and Risk of Hospitalization for Arrhythmias
Klatsky, A. L., Hasan, A. S., Armstrong, M. A., Udaltsova, N. V., & Morton, C. C. (2011) · The Permanente Journal · doi:10.7812/tpp/11-020 · Cited by 90
Mattioli, A. V., Bonatti, S., ZENNARO, M., & Mattioli, G. (2005) · EP Europace · doi:10.1016/j.eupc.2004.02.006 · Cited by 83
Yeragani, V. K., Krishnan, S., Engels, H. J., & Gretebeck, R. (2005) · Depression and Anxiety · doi:10.1002/da.20061 · Cited by 74
Mukamal, K. J., Hallqvist, J., Hammar, N., Ljung, R., Gémes, K., Ahlbom, A., Ahnve, S., & Janszky, I. (2009) · American Heart Journal · doi:10.1016/j.ahj.2008.11.009 · Cited by 69
Acute effects of caffeine ingestion on signal-averaged electrocardiograms
Donnerstein, R. L., Zhu, D. C., Samson, R. A., Bender, A. M., & Goldberg, S. J. (1998) · American Heart Journal · doi:10.1016/s0002-8703(98)70011-0 · Cited by 55
Diet and Risk of Atrial Fibrillation - Epidemiologic and Clinical Evidence -
Gronroos, N. N., & Alonso, Á. (2010) · Circulation Journal · doi:10.1253/circj.cj-10-0820 · Cited by 41
Glatter, K. A., Myers, R., & Chiamvimonvat, N. (2012) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-012-0193-6 · Cited by 32
Atrial fibrillation associated with chocolate intake abuse and chronic salbutamol inhalation abuse
Patanè, S., Marte, F., Rosa, F. C. L., & Rocca, R. L. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.12.159 · Cited by 27
Caffeine-Related Atrial Fibrillation
Artin, B., Singh, M., Richeh, C., Jawad, E., Arora, R., & Khosla, S. (2010) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e3181df8cf8 · Cited by 27
Caron, M., Song, J., Ammar, R., Kluger, J., & White, C. M. (2001) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1046/j.1365-2710.2001.00336.x · Cited by 27
(1972) · PubMed · Cited by 22
Coffee, caffeine and health: What's in your cup?
Lean, M. E. J., & Crozier, A. (2012) · Maturitas · doi:10.1016/j.maturitas.2012.04.005 · Cited by 19
Cited by
Sorted by citations
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A. M., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001193 · Cited by 3,145
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933
International Society of Sports Nutrition Position Stand: Caffeine and Exercise Performance
Guest, N. S., VanDusseldorp, T. A., Nelson, M. T., Grgic, J., Schoenfeld, B. J., Jenkins, N. D. M., Arent, S. M., Antonio, J., Stout, J. R., Trexler, E. T., et al. (2021) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-020-00383-4 · Cited by 665
Interindividual Differences in Caffeine Metabolism and Factors Driving Caffeine Consumption
Nehlig, A. (2018) · Pharmacological Reviews · doi:10.1124/pr.117.014407 · Cited by 632
Scientific Opinion on the safety of caffeine
EFSA Panel on Dietetic Products, N. A. A. (. (2015) · EFSA Journal · doi:10.2903/j.efsa.2015.4102 · Cited by 613
“Two systematic reviews and meta-analyses of prospective cohort studies have specifically addressed the association between habitual caffeine consumption and risk of atrial fibrillation (AF) (Caldeira et al., 2013; Cheng et al., 2014).”
Background
Metadata
- Authors
- Caldeira, D., Martins, C., Alves, L. B., Pereira, H., Ferreira, J. J., & Costa, J.
- Affiliations
- University of Lisbon (PT)
- Hospital Garcia de Orta (PT)
- Corresponding author
- Caldeira, Daniel
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2013-09-05
- Volume
- 99
- Issue
- 19
- Pages
- 1383-1389
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2148523405
- Cited by
- 109
- References
- 54
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 11 · 2023: 7 · 2022: 9 · 2021: 6 · 2020: 8 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 10 · 2015: 14 · 2014: 9 · 2013: 2
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Coffee research and impacts
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- caffeine, atrial fibrillation, coffee consumption, caffeine dose, arrhythmia risk factors
- MeSH terms
- Atrial Fibrillation, Caffeine, Coffee, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Risk Factors, Odds Ratio, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review