Coffee, Atrial Fibrillation, and Circulating Ceramides in Patients with Chronic Heart Failure

Ceramides are sphingolipids that play roles as structural lipids and as second messengers in biological processes. Circulating ceramides are influenced by diet/food and predict major cardiovascular (CV) events, such as atrial fibrillation (AF). In 1227 patients with symptomatic chronic heart failure (HF), an association between diet and ceramides was found for coffee consumption of ≥3 cups and Cer(d18:1/24:0). Increased Cer(d18:1/24:0) was associated with lower incident AF (24.3% <i>vs</i> 15.4% tertile 1 <i>vs</i> 3, <i>P</i> = 0.016) and lower CV mortality (28.4% <i>vs</i> 12.0% tertile 1 <i>vs</i> 3, <i>P</i> < 0.0001). For coffee consumption, only an association with incident AF was found (24.5% never, 5.2% ≥3 cups). These inverse associations with AF were confirmed in survival analyses corrected for biomarkers (Cer(d18:1/24:0) HR: 0.79, <i>P</i> = 0.018; coffee consumption HR: 0.22, <i>P</i> = 0.001). In conclusion, higher coffee intake was associated with a lower risk of incident AF and with higher concentrations of Cer(d18:1/24:0). Cer(d18:1/24:0) was inversely associated to risk of AF.