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Study Title and Description

Coffee, CYP1A2 genotype, and risk of myocardial infarction.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on cardiovascular outcomes?
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Primary Publication Information
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TitleData
Title Coffee, CYP1A2 genotype, and risk of myocardial infarction.
Author MC Cornelis,A El-Sohemy,EK Kabagambe,H Campos,
Country
Year 2006
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Cardiovascular Design
Design Details
Question... Follow Up Answer Follow-up Answer
What outcome is being evaluated in this paper? Cardiovascular
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What is the objective of the study (as reported by the authors)? The purpose of this study was to determine whether CYP1A2 genotype modifies the association between intake of caffeinated coffee and risk of nonfatal MI.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) Study Design and Participants The catchment area for this study comprised 7071 km2 and 2,057,000 individuals living in Costa Rica who are self-described Hispanic Americans. This area included 36 counties in the Central Valley of Costa Rica representing a full range of socioeconomic levels, as well as urban, periurban, and rural lifestyles. Medical services in this area were covered by 6 large hospitals, which are part of the National Social Security System. Eligible case participants were men and women who were survivors of a first acute MI as diagnosed by a cardiologist at any of the 6 recruiting hospitals in the catchment area between 1994 and 2004. To achieve 100% ascertainment, the hospitals were visited daily by the study fieldworkers. All cases were confirmed by 2 independent cardiologists according to the World Health Organization criteria for MI, which require typical symptoms plus either elevation in cardiac enzyme levels or diagnostic change in electrocardiogram tracings. Enrollment was carried out while cases were in the hospital’s step-down unit. Case participants were ineligible if they died during hospitalization, were 75 years or older on the day of their first MI, were physically or mentally unable to answer the questionnaire, or had a previous hospital admission related to cardiovascular disease. One control participant for each case, matched for age (±5 years), sex, and area of residence (county), was randomly selected using information available at the National Census and Statistics Bureau of Costa Rica. Because of the comprehensive social services provided in Costa Rica, all persons living in the catchment areas had access to medical care without regard to income. Therefore, control participants came from the source population that gave rise to the cases and are not likely to have had cardiovascular disease that was not diagnosed because of poor access to medical care. Controls were ineligible if they were physically or mentally unable to answer the questionnaires or if they had had a previous hospital admission related to MI or other cardiovascular disease. Participation for eligible cases and controls was 98% and 88%, respectively. All participants were visited at their homes for collection of biological specimens and information on diet, medical history, and anthropometric measurements. [NOTE: 2014 cases and 2014 controls included in study] All data were collected by trained fieldworkers during an interview using 2 questionnaires consisting of closed-ended questions regarding smoking, sociodemographic characteristics, socioeconomic status, physical activity, diet, and medical history including use of medication and personal history of diabetes and hypertension. Information on dietary intake was collected using a 135-item semi-quantitative food frequency questionnaire (FFQ) specifically developed and validated to assess dietary intake during the past year in the Costa Rican population. Included in the FFQ were questions related to the consumption of caffeinated coffee, tea, cola beverages, and chocolate. The standard portion size for coffee in the FFQ was fixed as 1 cup equivalent to 250 mL. Participants were categorized into 4 groups with reported coffee intakes of less than 1, 1, 2 to 3, or 4 or more 250-mL cups per day. CYP1A2 Genotyping Blood samples were collected in the morning at the participant’s home after an overnight fast and were centrifuged to separate the plasma and leukocytes for DNA isolation by standard procedures. TheCYP1A2*1F(rs762551) polymorphism was detected by restriction fragment–length polymorphism polymerase chain reaction without knowledge of case-control status. The genotype distribution among controls did not deviate from Hardy-Weinberg equilibrium according to a Pearson chi-square test with 1 df. Statistical Analysis All data were analyzed using SAS version 8.2 (SAS Institute Inc, Cary, NC); P<0.05 was considered statistically significant. DNA was available from 4369 participants (2113 cases and 2256 controls). A total of 341 participants were excluded because they were missing data on confounders (33 cases, 26 controls), could not be genotyped (63 cases, 73 controls), or became unmatched because of missing data (3 cases, 143 controls), leaving 2014 matched case-control pairs for the final analysis. Because of the matched design, significant differences in the distribution of variables between cases and controls were tested using the McNemar test (categorical variables) and either paired t tests or Wilcoxon signed rank tests (continuous variables). Categorical and continuous non-dietary and energy-adjusted dietary variables were assessed for potential confounding by measuring their effect on the model parameter estimates using the likelihood ratio test. Odds ratios (ORs) and Wald 95% confidence intervals (95% CIs) were estimated by conditional logistic regression to determine the effect of coffee intake on the risk of MI, with the lowest level of coffee intake (<1 cup/d) as the reference group. Confounders included in the final models were smoking; alcohol consumption; history of diabetes, history of hypertension; quintiles of the continuous variables waist-hip ratio, physical activity, and income; and energy-adjusted intakes of sucrose, saturated fat, polyunsaturated fat, and trans fat. We evaluated potential gene x coffee interactions by determining the relation between coffee intake and the risk of MI for each genotype using conditional and unconditional logistic regression (with matching variables in the model) and by comparing –2 log (likelihood) ratios from a model with coffee and gene main effects only and from another that included their interaction term. Because results for conditional and unconditional regressions were similar, we report only the data from unconditional analyses to maximize the number of participants. Results are presented using a dominant *1F allele model with *1A/*1F and *1F/*1F genotypes combined. We also investigated whether smoking status (nonsmoker, current smoker) or age (below/above median) modified the relationship between CYP1A2 genotype and MI associated with coffee intake, by performing stratified analyses and evaluating the gene x coffee interaction separately for each subgroup.
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Nonfatal myocardial infarction
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List additional health endpoints (separately). 2
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List additional health endpoints (separately).3
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List additional health endpoints (separately).4
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List additional health endpoints (separately).5
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List additional health endpoints (separately).6
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Clinical, physiological, other Clinical
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What is the study design? Case-Control
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Objective
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Optional: Name of Method or short description All cases were confirmed by 2 independent cardiologists according to the World Health Organization criteria for MI, which require typical symptoms plus either elevation in cardiac enzyme levels or diagnostic change in electrocardiogram tracings.
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Caffeine (general)
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Coffee, Chocolate, energy drink, gum, medicine/supplement, soda, tea, other? Coffee
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Measured or self reported? Self-report
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Children, adolescents, adults, or pregnant included? Adults
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) <1 250 ml cup/day compared to 1, 2-3, or >/= 4 cups/day
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) Confounders included in the final models were smoking; alcohol consumption; history of diabetes, history of hypertension; quintiles of the continuous variables waist-hip ratio, physical activity, and income; and energy-adjusted intakes of sucrose, saturated fat, polyunsaturated fat, and trans fat.
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What conflicts of interest were reported? Financial Disclosures: None reported.
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Refid 16522833
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What were the sources of funding? This research was supported by grants from the Canadian Institutes of Health Research (MOP-53147) and the National Institutes of Health (HL 60692 and HL 071888).
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Results & Comparisons

No Results found.