Moderate coffee consumption safe after AMI

Clinical Question

Is coffee consumption safe after acute myocardial infarction?

Bottom Line

Coffee consumption does not increase the risk of cardiovascular events following acute myocardial infarction (AMI). (LOE = 1b)


Silletta MG, Marfisi R, Levantesi G, et al, for the GISSI-Prevenzione Investigators. Coffee consumption and risk of cardiovascular events after acute myocardial infarction. Circulation 2007;116(25):2944-2951.  [PMID:18056527]

Study Design

Cohort (prospective)


Self-funded or unfunded


Outpatient (any)


The data on coffee consumption are somewhat conflicting. These authors used data from the Italian GISSI-Prevenzione trial, a randomized trial of vitamin E and omega-3 fatty acids in 11,323 adults with recent acute myocardial infarction (AMI). Follow-up was excellent (more than 99%). Coffee consumption was ascertained at baseline and again at 6 months, 18 months, and 42 months. Consumption was categorized as none, less than 2 cups, 2 to 4 cups, and more than 4 cups per day. Heavy coffee users were more likely to be male, obese, smokers, and young. There were also differences in comorbidities and medication use between heavy coffee users and others. In the unadjusted analysis, heavy coffee drinking was protective for the primary outcome of subsequent cardiovascular events (cardiovascular death, nonfatal AMI, or nonfatal stroke). In the analysis adjusted for age, sex, and smoking, that benefit persisted, but it was no longer significant. The relative risk of coffee consumption compared with no coffee was 1.02 (95% CI, 0.87-12) for less than 2 cups, 0.91 (0.75-1.09) for 2 to 4 cups, and 0.88 (0.64-1.2) for more than 4 cups.