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Study Title and Description

Cardiac arrest in a young man following excess consumption of caffeinated "energy drinks".



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on acute toxicity*?
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Primary Publication Information
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TitleData
Title Cardiac arrest in a young man following excess consumption of caffeinated "energy drinks".
Author AJ Berger,K Alford,
Country
Year 2009
Numbers

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


Extraction Form: Acute Toxicity - Study Design Details
Arms
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Design Details
Question... Follow Up Answer Follow-up Answer
Refid 19120009
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What outcome is being evaluated in this paper? Acute
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What is the objective of the study (as reported by the authors)? To report a case report of a 28 year old motor cross driver (otherwise healthy) male who suffered a myocardial infarction after a race. He had ingested approximately 640 mg of caffeine over a 7 hour period from an energy drink (8 cans), the authors speculate the caffeine and taurine containing drink and strenuous exercise produced the myocardial ischemia through coronary vasospasm
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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) self reported caffeine consumption, patient admit to ED after being revived after collapsing at a motocross race. History taken, ECG, chest X-ray, tomography of chest and brain. No blood work for caffeine but for other drugs and standard labs.
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How many outcome-specific endpoints are evaluated? 5
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Medical history - smoker; no family history of early coronary heart disease or myocardial infarction at a young age. Also no reported drug use
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List additional health endpoints (separately). Blood work indicated increased troponin and decreased potassium, negative drug screen, steroids and caffeine were not measured.
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List additional health endpoints (separately)
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Notes
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Clinical Clinical
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Physiological Physiological
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Other
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What is the study design? Case report
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Subjective
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Optional: Name of Method or short description described above (ECG, Xray of chest, tomography of chest and brain and blood work)
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Caffeine (general)
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Coffee
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Chocolate
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Energy drinks Energy drinks
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Gum
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Medicine/Supplement
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Soda
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Tea
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Measured
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Self-report Self-report
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Children
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Adolescents
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Adults Adults
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Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) none- case report
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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) smoker and possible steroid use (lack of use not confirmed and noted as such) drug use (but confirmed clean)
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Provide a general description of results (as reported by the authors). patient had Electrocardiographic and echocardiographic features indicative of transmural ischemia. Authors speculate coronary vasospasm as an underlying abnormality, cause of hypokalemia unclear. patient was treated (intubation, after extubation discharged after 6 days).
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? Authors postulate a role of caffeine in causing the coronary vasospasm. They report that caffeine and taurine have been shown in vivo to have physiological effects on intracellular calcium in vascular smooth muscle which could be the mechanism.
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What were the sources of funding? not reported
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What conflicts of interest were reported? stated that none existed
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Does the exposure (dose) need to be standardized to the SR? Multiple metrics
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest). 7-8 cans x 80mg/can = 560 mg-640 mg caffeine
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  myocardial infarction, 560-640 mg (7-8 energy drinks) over 7 hours
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. Authors did not comment on stress of motor cross riding and the fact that the individual was smoker
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What is the importance of the study with respect to the adverseness of the outcome? Important
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Baseline Characteristics
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Results & Comparisons

No Results found.
Adverse Events
Arm or Total Title Description Comments

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