International Journal of Cardiovascular Sciences. 19/Sep/2025;38:e20250006.

Chocolate Consumption Does Not Reduce the Risk of Cardiovascular Events and Increases the Risk of Gastrointestinal Bleeding One Year After the First Myocardial Infarction

Daniel Medeiros Moreira , Lara Marcon Dandolini, Tammuz Fattah , Rodrigo de Moura Joaquim , Roberto Leo da Silva

DOI: 10.36660/ijcs.20250006

Introduction

Coronary artery disease is the leading cause of death worldwide and presents a great social and financial burden for healthcare systems. Although the entire process of atherosclerotic plaque formation and progression to myocardial infarction is driven by inflammation, few therapies targeting this mechanism are available (e.g., colchicine).^,

In this context, foods with bioactive properties, such as chocolate, have drawn interest for their potential cardiovascular benefits. Prospective studies and meta-analyses have demonstrated that chocolate consumption may reduce the incidence of coronary events.^– Chocolate composition varies according to cocoa content; for example, dark chocolate is rich in flavonoids (epicatechin, catechin, and procyanidins) and methylxanthines (theobromine and caffeine). Chocolate and cocoa are not interchangeable terms. Cocoa refers to the non-fat component of cocoa liquor (finely ground cocoa beans), which is used in chocolate production or as cocoa powder, typically containing about 12% fat. Cocoa liquor contains approximately 55% cocoa butter, and the remaining part is composed of cocoa solids, often indicated on chocolate packages. In contrast, chocolate is the final solid product resulting from the combination of cocoa, cocoa butter, sugar, and other ingredients.

[…]