DECAF is hitting the headlines at the American Heart Association this weekend (https://bit.ly/4p2s1pD) and has been simultaneously published in JAMA (https://jamanetwork.com/journals/jama/fullarticle/2841253).
Simply, it takes a group of coffee drinkers with persistent Atrial Fibrillation or flutter and randomises them to keep drinking coffee as normal or to abstain from coffee and all caffeinated products. They excluded those who said they thought they couldn’t abstain. The outcome was a recurrence of AF or flutter over 6 months.
The results were 45% recurrence in the coffee consuming group and 69% in the abstinence group.
The study & media are reporting that coffee consumption may lower the rate of AF. The abstract results state: “In the primary analysis, AF or atrial flutter recurrence was less in the coffee consumption (47%) than the coffee abstinence (64%) group, resulting in a 39% lower hazard of recurrence (hazard ratio, 0.61 [95% CI, 0.42-0.89]; P = .01).”
For me this is very wrong. It is the coffee consuming group that is the control arm not the abstinence group. The results should be something like ““In the primary analysis, AF or atrial flutter recurrence was more in the coffee abstinence group (64%) than the coffee consumption group, resulting in a 64% higher hazard, resulting in a 64% higher hazard of recurrence (hazard ratio,1.64 [95% CI, 1.12-2.38]; P = .01).” The advice being given should be that (at least for now) better to avoid going cold turkey on the coffee.
If they wanted to know if drinking coffee reduced AF then that study should start with non-coffee drinkers.
What is your take on this?
