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Tea Consumption and Infarct-Related Ventricular Arrhythmias: The Determinants of Myocardial Infarction Onset Study

Divisions of General Medicine and Primary Care (K.J.M., M.A.)
Cardiology (M.A.M.)
Beth Israel Deaconess Medical Center, Department of Epidemiology (M.M., M.A.M.)
Harvard School of Public Health, Division of Cardiology (J.E.M.), Massachusetts General Hospital, Boston, Massachusetts

Address reprint requests to: Kenneth J. Mukamal, MD, MPH, MA, Beth Israel Deaconess Medical Center, Division of General Medicine and Primary Care Research Program, 1309 Beacon Street, 2nd Floor, Brookline, MA 02446. E-mail: kmukamal{at}bidmc.harvard.edu

Background: Tea consumption is associated with lower post-infarct mortality among patients with acute myocardial infarction. We previously found preliminary evidence that tea consumption may also be associated with lower risk of infarct-related ventricular arrhythmias.

Methods: Between 1989 and 1996, 3882 subjects with AMI were enrolled in the two phases of the Determinants of Myocardial Infarction Onset Study a median of four days after admission. Trained interviewers assessed self-reported usual tea and coffee consumption during the year prior to infarction with a standardized questionnaire. We examined the prevalence of ventricular arrhythmias in the two phases of the study separately and together.

Results: Among the 1912 patients with complete information in the first phase, the prevalence of ventricular arrhythmias was 16% among abstainers from tea, 11% among moderate tea drinkers (<14 cups per week), and 14% among heavier tea drinkers (14 cups per week) (p homogeneity = 0.03). Among the 1791 patients with comparable information in the second phase, the corresponding prevalence rates were 11%, 8%, and 8%, respectively (p = 0.06). When the phases were combined, the adjusted odds ratios for VA were 0.7 (95% confidence interval, 0.6–0.9) among moderate tea drinkers and 0.9 (95% confidence interval, 0.7–1.2) among heavier tea drinkers. The findings were of similar direction for both ventricular tachycardia and fibrillation. In contrast, there was higher risk of VA with increasing coffee intake (odds ratio for >14 cups per week 1.3; 95% confidence interval, 1.0–1.7; p trend 0.02).

Conclusions: Moderate tea intake is associated with a lower prevalence, and higher coffee intake with a slightly higher prevalence, of ventricular arrhythmias among patients hospitalized with acute myocardial infarction. If the association with tea intake is confirmed, it may suggest new approaches to prevention of ischemia-related arrhythmias.