Turk Kardiyol Dern Ars. 2026 Oct;54(Suppl 1):190-206. doi: 10.5543/tkda.2026.44773.
ABSTRACT
Energy drink (ED) consumption has been temporally associated with acute coronary events, particularly in young individuals; however, causality remains uncertain. We aimed to characterize coronary events reported following ED consumption and evaluate their clinical features, underlying mechanisms, and causal plausibility. Two new cases of premature myocardial infarction (MI) were combined with cases identified through a systematic review of the literature published through September 2026. Patient-level data on ED exposure, cardiovascular risk factors, coronary mechanisms, and clinical outcomes were analyzed. Causality was assessed using an adapted World Health Organization-Uppsala Monitoring Centre (WHO-UMC) framework. The cohort comprised 31 male patients (29 previously published cases and two new cases; mean age, 25.6 +- 5.4 years). Twenty-eight patients (90.3%) met strict criteria for MI or acute coronary syndrome (ACS), and 25 (80.6%) presented with ST-segment elevation myocardial infarction (STEMI). Coronary thrombosis was documented in 13 patients (41.9%), coronary vasospasm in eight (25.8%), and spontaneous coronary artery dissection in three (9.7%). Additional exposures or physiological stressors were identified in 22 patients (71.0%). The initial left ventricular ejection fraction was below 50% in 10 of the 19 evaluable patients (52.6%). Cardiac arrest occurred in six patients (19.4%), and two patients died (6.5%). Causality was classified as probable/likely in five patients (16.1%), possible in 23 (74.2%), and unlikely in three (9.7%). Coronary events temporally associated with ED consumption predominantly affected young men, involved heterogeneous mechanisms, and were associated with potentially severe outcomes. The frequent presence of coexisting risk factors and limited causal evidence preclude definitive attribution of these events to ED consumption. Prospective controlled studies are needed to clarify the independent cardiovascular risks associated with ED consumption.
PMID:42952259 | DOI:10.5543/tkda.2026.44773