Coffee Consumption and Coronary Artery Calcium Score
Coffee Consumption and Coronary Artery Calcium Score
Coffee is one of the dietary factors associated with cardiovascular disease (CVD) but its
 role in the cardiovascular system is not yet clear. Moreover, available evidence for the
 relation between coffee intake with subclinical atherosclerosis is limited and inconsistent.
 The aim of this study was to evaluate the association between habitual coffee consumption and
 the presence of subclinical atherosclerosis measured as coronary artery calcium (CAC) in the
 Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). This is a cross-sectional study
 based on baseline data from participants of the cohort ELSA-Brasil. In this analysis, only
 participants living in São Paulo with no prior history of CVD aged 35 to 74 years who
 underwent a CAC measurement (n=4,426) were included. Dietary data were collected using a
 validated food frequency questionnaire. Coronary calcification was detected with computed
 tomographic and it was expressed as Agatston units. CAC was further categorized as 0 or >0,
 and <100 or ≥100.
The Longitudinal Study of Adult Health (ELSA-Brasil) is a cohort study designed to identify
 risk factors for diabetes and CVD. Briefly, the cohort comprises 15,105 civil servants, aged
 35 to 74 years at baseline, who were sampled from universities or research institutions
 located in six cities (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and
 Vitoria) of three different regions of Brazil. Baseline assessment was conducted from August
 2008 to December 2010 and consisted of an approximately 7-hour evaluation, which included
 personal interviews conducted by trained personnel. These interviews focused on
 sociodemographic characteristics, health and medical history, occupational exposure, family
 history of disease, reproductive health, health care, psychosocial factors, body weight
 history and body image, food consumption, smoking, alcohol consumption, physical activity,
 medication use, cognitive function, mental health, and clinical and laboratory measurements.
 In addition, the participants at the ELSA-Brasil site in São Paulo were invited to perform a
 computed tomographic (CT) examination to quantify coronary artery calcium (CAC).

 Thus, for the current investigation, only participants of the ELSA-Brasil of São Paulo
 Research Center who submitted to CAC determination (n=4,549) were included. In addition, in
 the present analysis, we considered individuals without missing data at baseline for coffee
 intake, and no self-reported history of cardiovascular disease defined as prior myocardial
 infarction, angina, stroke, heart failure, and coronary revascularization. Therefore, the
 final study sample comprised 4,426 individuals who submitted to CAC measurements and did not
 fulfill exclusion criteria to participate in this subset of the study.

 The ELSA-Brasil protocol was approved at all six centers by the institutional review boards
 addressing research in human participants. All the subjects signed a written informed consent
 form.
Inclusion Criteria:

 -  For the current investigation, only participants of the ELSA-Brasil of São Paulo
 Research Center who submitted to CAC determination (n=4,549) were included.

 Exclusion Criteria:

 -  Missing data at baseline for coffee intake, and self-reported history of
 cardiovascular disease defined as prior myocardial infarction, angina, stroke, heart
 failure, and coronary revascularization.