Risk Thresholds for Total and Beverage-Specific Alcohol Consumption and Incident Atrial Fibrillation

Background— Evidence on the relationship of a wide range of alcohol consumption with risk of incident atrial fibrillation has been limited. Methods— Between 1991 and 1995, 8602 Japanese men and women aged 30 to 80 years and free of clinical atrial fibrillation took part in the first examination of the Circulatory Risk in Communities Study(CIRCS)- a population based cohort study of cardiovascular risk factors, cardiovascular disease incidence, and their trends in Japanese communities. In the first examination, we checked a detailed medical history, physical examination, blood and urine examination, and electrocardiogram (ECG). An interviewer obtained histories in detail for weekly alcohol intake. In the follow-up period, incident atrial fibrillations were ascertained by annual ECG record and medical history of treatment of atrial fibrillation. ECGs were coded with the Minnesota Code by trained physician-epidemiologists. Differences in baseline characteristics between atrial fibrillation cases and controls were compared using Student t-tests or chi-squared tests. The hazard ratios (HRs) of incidence of atrial fibrillation and 95% confidence interval (CI) relative to the never-drinking group were calculated with adjustment for age and other potential confounding factors using the Cox proportional hazard model. Results— During an average follow-up of 6.4 years, 290 incident atrial fibrillation occurred. The higher incidence rate of atrial fibrillation was observed among participants with more than 69 g of ethanol drinking per week, compared with less than 69 g of ethanol drinking per week. On the other hand, light to moderate alcohol consumption was not associated with risk of atrial fibrillation. Compared with the never drinking group, the multivariable-adjusted HRs of past, light (<23 g), light moderate (23-46 g), moderate (46-69 g), and heavy (>69 g) drinking groups were 1.20 (95% CI, 0.61-2.35), 0.85 (95% CI, 0.57-1.27), 1.05 (95% CI, 0.63-1.75), 1.34 (95% CI, 0.78-2.32), and 2.92 (95% CI, 1.61-5.28), respectively. Conclusions— Heavy alcohol consumption was associated with the higher risk of atrial fibrillation, whereas there was no association of less than moderate alcohol consumption and atrial fibrillation.

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Abstract 12385: Past Alcohol Consumption and Incident Atrial Fibrillation

Circulation ◽

10.1161/circ.132.suppl_3.12385 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Shalini Dixit ◽

Alvaro Alonso ◽

Elsayed Z Soliman ◽

Lin Y Chen ◽

Gregory M Marcus

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Alcohol Use ◽

Population Based ◽

Self Report ◽

Atherosclerosis Risk In Communities ◽

Increased Risk ◽

Before And After ◽

Dietary Intake Assessment ◽

Aric Study

Introduction: Although current alcohol consumption appears to be a risk factor for incident atrial fibrillation (AF), limitations related to self-reported alcohol use and confounding in observational studies limit the certainty of conclusions regarding causality. Whether cessation of alcohol consumption can protect against incident AF remains unknown. Methods: We examined all participants in the Atherosclerosis Risk in Communities (ARIC) study, a population-based cohort of 15,792 men and women aged 45-65, without prevalent AF. Past alcohol consumption was assessed via self-report during the baseline dietary intake assessment. Cases of incident AF were ascertained via study ECGs, hospital discharge ICD-9 codes, and death certificates. Results: Among 15,262 participants with complete survey data, 2,898 (19.0%) were former drinkers. During an average follow-up of 17.4 years, there were 380 cases of incident AF in former consumers. Both before and after adjustment for potential confounders, a longer duration of alcohol abstinence was associated with a lower risk of developing AF; previously consuming alcohol for a longer duration and consuming a greater quantity of alcohol were each associated with a higher risk of developing AF (Table). Conclusions: Among former drinkers, the number of years of drinking and the amount of alcohol consumed may each confer an increased risk of AF. Given that a longer duration of abstinence was associated with a decreased risk of AF, modification of alcohol use could potentially play a role in AF prevention.

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Risk thresholds for alcohol consumption

The Lancet ◽

10.1016/s0140-6736(18)32197-4 ◽

2018 ◽

Vol 392 (10160) ◽

pp. 2167

Author(s):

Warren Thompson

Keyword(s):

Alcohol Consumption ◽

Risk Thresholds

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Causal Association Between Alcohol Consumption and Atrial Fibrillation: A Mendelian Randomization Study

Korean Circulation Journal ◽

10.4070/kcj.2021.0269 ◽

2022 ◽

Vol 52 ◽

Author(s):

Jung-Ho Yang ◽

Ji-An Jeong ◽

Sun-Seog Kweon ◽

Young-Hoon Lee ◽

Seong-Woo Choi ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Mendelian Randomization ◽

Causal Association

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Past alcohol consumption and incident atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study

PLoS ONE ◽

10.1371/journal.pone.0185228 ◽

2017 ◽

Vol 12 (10) ◽

pp. e0185228 ◽

Cited By ~ 7

Author(s):

Shalini Dixit ◽

Alvaro Alonso ◽

Eric Vittinghoff ◽

Elsayed Soliman ◽

Lin Y. Chen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

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Correction: Past alcohol consumption and incident atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study

PLoS ONE ◽

10.1371/journal.pone.0190329 ◽

2017 ◽

Vol 12 (12) ◽

pp. e0190329

Author(s):

Shalini Dixit ◽

Alvaro Alonso ◽

Eric Vittinghoff ◽

Elsayed Z. Soliman ◽

Lin Y. Chen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

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Heavy Alcohol Consumption and Risk of Atrial Fibrillation

Circulation Journal ◽

10.1253/circj.cj-13-1387 ◽

2014 ◽

Vol 78 (4) ◽

pp. 955-961 ◽

Cited By ~ 26

Author(s):

Fumihiko Sano ◽

Tetsuya Ohira ◽

Akihiko Kitamura ◽

Hironori Imano ◽

Renzhe Cui ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption

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Effect of alcohol consumption on the risk of adverse events in atrial fibrillation: from the COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry

EP Europace ◽

10.1093/europace/euaa340 ◽

2020 ◽

Author(s):

Chewan Lim ◽

Tae-Hoon Kim ◽

Hee Tae Yu ◽

So-Ryoung Lee ◽

Myung-Jin Cha ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Adverse Events ◽

Reference Group ◽

Symptom Control ◽

Adverse Outcomes ◽

Heavy Alcohol ◽

Hazard Ratios ◽

Increased Risk ◽

Heavy Alcohol Consumption

Abstract Aims The aim of this study is to determine the relationship between alcohol consumption and atrial fibrillation (AF)-related adverse events in the AF population. Methods and results A total of 9411 patients with nonvalvular AF in a prospective observational registry were categorized into four groups according to the amount of alcohol consumption—abstainer-rare, light (<100 g/week), moderate (100–200 g/week), and heavy (≥200 g/week). Data on adverse events (ischaemic stroke, transient ischaemic attack, systemic embolic event, or AF hospitalization including for AF rate or rhythm control and heart failure management) were collected for 17.4 ± 7.3 months. A Cox proportional hazard models was performed to calculate hazard ratios (HRs), and propensity score matching was conducted to validate the results. The heavy alcohol consumption group showed an increased risk of composite adverse outcomes [adjusted hazard ratio (aHR) 1.32, 95% confidence interval (CI) 1.06–1.66] compared with the reference group (abstainer-rare group). However, no significant increased risk for adverse outcomes was observed in the light (aHR 0.88, 95% CI 0.68–1.13) and moderate (aHR 0.91, 95% CI 0.63–1.33) groups. In subgroup analyses, adverse effect of heavy alcohol consumption was significant, especially among patients with low CHA2DS2-VASc score, without hypertension, and in whom β-blocker were not prescribed. Conclusion Our findings suggest that heavy alcohol consumption increases the risk of adverse events in patients with AF, whereas light or moderate alcohol consumption does not.

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Frequent drinking is a more important risk factor for new-onset atrial fibrillation than binge drinking: a nationwide population-based study

EP Europace ◽

10.1093/europace/euz256 ◽

2019 ◽

Cited By ~ 5

Author(s):

Yun Gi Kim ◽

Kyung-Do Han ◽

Jong-Il Choi ◽

Ki Yung Boo ◽

Do Young Kim ◽

...

Keyword(s):

Atrial Fibrillation ◽

Risk Factor ◽

Alcohol Consumption ◽

Binge Drinking ◽

Alcohol Intake ◽

Significant Risk ◽

Drinking Session ◽

Onset Atrial Fibrillation ◽

Frequent Drinking ◽

New Onset

Abstract Aims Heavy consumption of alcohol is a known risk factor for new-onset atrial fibrillation (AF). We aimed to evaluate the relative importance of frequent drinking vs. binge drinking. Methods and results A total of 9 776 956 patients without AF who participated in a national health check-up programme were included in the analysis. The influence of drinking frequency (day per week), alcohol consumption per drinking session (grams per session), and alcohol consumption per week were studied. Compared with patients who drink twice per week (reference group), patients who drink once per week showed the lowest risk [hazard ratio (HR) 0.933, 95% confidence interval (CI) 0.916–0.950] and those who drink everyday had the highest risk for new-onset AF (HR 1.412, 95% CI 1.373–1.453), respectively. However, the amount of alcohol intake per drinking session did not present any clear association with new-onset AF. Regardless of whether weekly alcohol intake exceeded 210 g, the frequency of drinking was significantly associated with the risk of new-onset AF. In contrast, when patients were stratified by weekly alcohol intake (210 g per week), those who drink large amounts of alcohol per drinking session showed a lower risk of new-onset AF. Conclusion Frequent drinking and amount of alcohol consumption per week were significant risk factors for new-onset AF, whereas the amount of alcohol consumed per each drinking session was not an independent risk factor. Avoiding the habit of consuming a low but frequent amount of alcohol might therefore be important to prevent AF.

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