Heavy drinking habits are associated with worse in-hospital outcomes in patients with acute coronary syndrome

Abstract Introduction The association between alcohol consumption and the occurrence of coronary heart disease is well described in literature. Data regarding the impact of regular alcohol consumption on in-hospital outcomes in the setting of acute coronary syndrome (ACS) are lacking. Purpose We aimed to evaluate the impact of self-reported alcohol consumption on in-hospital outcomes in patients with ACS. Methods Data derived from patients enrolled between 2007 and 2019 in the Acute Myocardial Infarction in Switzerland (AMIS) Plus registry were retrospectively analyzed. The primary endpoint was all-cause in-hospital mortality, while secondary endpoints were set as incidence of major adverse cardiac and cerebrovascular events (MACCEs). Outcomes comparisons according to quantity of daily alcohol intake were also performed. Results Records concerning alcohol consumption were available in 25707 patients; 5298 of them (21%) fulfilled the criteria of regular alcohol consumption. Daily alcohol intake was reported in 4059 (77%), of these patients (regular drinkers) with 2640 light drinkers (≤2 drinks/day) and 1419 heavy drinkers (>2 drinks/day). Regular drinkers were predominantly male, younger, smokers, more comorbid and with a worse clinical presentation as compared to abstainers/occasional drinkers. In-hospital mortality and MACCEs of heavy drinkers were significantly higher compared to light drinkers (5.4% vs. 3.3% and 7.0% vs. 4.4%, both p=0.001). When tested together with GRACE risk score parameters, heavy alcohol consumption was independently associated to in-hospital mortality (p=0.004). Conclusions Heavy alcohol consumption is an additional independent predictor of in-hospital mortality in patients presenting with ACS. Figure 1. Study flowchart. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Swiss Heart Foundation

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Heavy Drinking Habits Are Associated with Worse In-Hospital Outcomes in Patients with Acute Coronary Syndrome: An Insight from the AMIS Plus Registry

Cardiology ◽

10.1159/000508928 ◽

2020 ◽

Vol 145 (12) ◽

pp. 757-765

Author(s):

Gregorio Tersalvi ◽

Luigi Biasco ◽

Dragana Radovanovic ◽

Hans Rickli ◽

Marco Roffi ◽

...

Keyword(s):

Alcohol Consumption ◽

Hospital Mortality ◽

Alcohol Intake ◽

Hospital Outcomes ◽

Heavy Alcohol ◽

Coronary Syndrome ◽

Daily Alcohol Intake ◽

Heavy Alcohol Consumption ◽

The Impact ◽

Regular Alcohol Consumption

Background: The association between alcohol consumption and the occurrence of coronary heart disease is well described in the literature, while data regarding the impact of regular alcohol consumption on in-hospital outcomes in the setting of acute coronary syndrome (ACS) are lacking. We aimed to evaluate the impact of self-reported alcohol consumption on in-hospital outcomes in patients with ACS. Methods: Data derived from patients enrolled between 2007 and 2019 in the Acute Myocardial Infarction in Switzerland (AMIS) Plus registry were retrospectively analyzed. Patients were stratified based on alcohol drinking pattern. Primary outcome was all-cause in-hospital mortality, while secondary outcomes were set as incidence of major adverse cardiac and cerebrovascular events (MACCEs). Outcome comparisons according to quantity of daily alcohol intake were also performed. Results: Records concerning alcohol consumption were available in 25,707 patients; 5,298 of them (21%) fulfilled the criteria of regular alcohol consumption. Regular drinkers were predominantly male, younger, smokers, more comorbid and with a worse clinical presentation as compared with abstainers/occasional drinkers. Daily alcohol intake was reported in 4,059 (77%) of these patients (regular drinkers). Among them, 2,640 were light drinkers (≤2 drinks/day) and 1,419 heavy drinkers (>2 drinks/day). In-hospital mortality and MACCEs of heavy drinkers were significantly higher compared with those of light drinkers (5.4 vs. 3.3% and 7.0 vs. 4.4%, both p = 0.001). When tested together with Global Registry of Acute Coronary Events risk score parameters, heavy alcohol consumption was independently associated with in-hospital mortality (p = 0.004). Conclusions: Our results support that heavy alcohol consumption is an independent predictor of in-hospital mortality in patients presenting with ACS.

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Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

Clinical Research in Cardiology ◽

10.1007/s00392-021-01857-4 ◽

2021 ◽

Author(s):

Yoichi Imori ◽

Ken Kato ◽

Victoria L. Cammann ◽

Konrad A. Szawan ◽

Manfred Wischnewsky ◽

...

Keyword(s):

Hospital Mortality ◽

Clinical Characteristics ◽

Ethnic Disparities ◽

Japanese Patients ◽

Learning Approach ◽

Takotsubo Syndrome ◽

Unique Identifier ◽

Hospital Outcomes ◽

Machine Learning Approach ◽

The Impact

Abstract Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

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Impact of timing of randomization after an acute coronary syndrome and subsequent events in patients with type 2 diabetes mellitus: an analysis of the EXAMINE trial

European Heart Journal ◽

10.1093/ehjci/ehaa946.3067 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Elharram ◽

A Sharma ◽

W White ◽

G Bakris ◽

P Rossignol ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Clinical Trials ◽

Type 2 Diabetes Mellitus ◽

Acute Coronary Syndrome ◽

Primary Outcome ◽

Funding Source ◽

Coronary Syndrome ◽

The Impact

Abstract Background The timing of enrolment following an acute coronary syndrome (ACS) may influence cardiovascular (CV) outcomes and potentially treatment effect in clinical trials. Using a large contemporary trial in patients with type 2 diabetes mellitus (T2DM) post-ACS, we examined the impact of timing of enrolment on subsequent CV outcomes. Methods EXAMINE was a randomized trial of alogliptin versus placebo in 5380 patients with T2DM and a recent ACS. The primary outcome was a composite of CV death, non-fatal myocardial infarction [MI], or non-fatal stroke. The median follow-up was 18 months. In this post hoc analysis, we examined the occurrence of subsequent CV events by timing of enrollment divided by tertiles of time from ACS to randomization: 8–34, 35–56, and 57–141 days. Results Patients randomized early (compared to the latest times) had less comorbidities at baseline including a history of heart failure (HF; 24.7% vs. 33.0%), prior coronary artery bypass graft (9.6% vs. 15.9%), or atrial fibrillation (5.9% vs. 9.4%). Despite the reduced comorbidity burden, the risk of the primary outcome was highest in patients randomized early compared to the latest time (adjusted hazard ratio [aHR] 1.47; 95% CI 1.21–1.74) (Figure 1). Similarly, patients randomized early had an increased risk of recurrent MI (aHR 1.51; 95% CI 1.17–1.96) and HF hospitalization (1.49; 95% CI 1.05–2.10). Conclusion In a contemporary cohort of T2DM with a recent ACS, early randomization following the ACS increases the risk of CV events including recurrent MI and HF hospitalization. This should be taken into account when designing future clinical trials. Figure 1 Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Takeda Pharmaceutical

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THE INFLUENCE OF HEAVY ALCOHOL CONSUMPTION ON HIV INFECTION AND PROGRESSION

Journal of Biological System ◽

10.1142/s0218339009003083 ◽

2009 ◽

Vol 17 (04) ◽

pp. 685-712 ◽

Cited By ~ 8

Author(s):

G. THOMAS ◽

E. M. LUNGU

Keyword(s):

Alcohol Consumption ◽

Demographic Data ◽

African Region ◽

Heavy Alcohol ◽

Infected People ◽

Aids Epidemic ◽

Heavy Alcohol Consumption ◽

The Impact ◽

Global Population ◽

Hiv Aids

The Sub-Sahara African region is inhabited by only 11% of the global population, but is home to 67% of the total HIV infected people and accounts for more than 70% of global AIDS deaths. In this study, we construct a mathematical model to investigate the effect of heavy alcohol consumption on the transmission and progression of HIV/AIDS, and to assess the impact of heavy drinkers on HIV/AIDS related social and health problems such as TB case load and number of orphans. Using demographic data for Botswana, we have shown that if more HIV/AIDS individuals had been de-addicted from heavy alcohol consumption, the severity of the HIV/AIDS epidemic and the impact of HIV/AIDS on the number of TB cases and orphans would have been significantly less than is the case currently. The study points to the vital need for counseling and education about the evils of heavy alcohol consumption and for alcohol de-addiction programmes.

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Norwegians and cheap alcohol: Consumption in a low price area

Nordisk Alkoholtisdkrift (Nordic Alcohol Studies) ◽

10.1177/145507259401100309 ◽

1994 ◽

Vol 11 (3) ◽

pp. 139-145

Author(s):

Georg Høyer ◽

Odd Nilssen ◽

Tormod Brenn ◽

Helge Schirmer

Keyword(s):

Alcohol Consumption ◽

Alcohol Intake ◽

Alcohol Policy ◽

Average Amount ◽

Self Reports ◽

Frequency Of Alcohol Intake ◽

The Impact ◽

Self Administered Questionnaire

Although the archipelago of Svalbard is a part of Norway (situated 78 degrees north), the area is subject to a different alcohol policy than on the Norwegian mainland. In Svalbard, the prices of alcohol are low (in comparison to those on the mainland): however, personal quotas are in force in order to control sales. This study compares the level of alcohol consumption on Svalbard and on the Norwegian mainland. The comparison is based on self-reports of alcohol consumption. In Svalbard all of the residents eighteen years or older were screened by a self-administered questionnaire: alcohol consumption was recorded as an intake of alcohol measured in units during the last week before filling in the questionnaire. On the mainland, the recording was carried out through personal interviews in which respondents were asked about the frequency of alcohol intake and the average amount of intake for each episode in representative periods. The results showed that men in Svalbard consumed 1.7 times more alcohol then the men consumed on the mainland: women, 1.4 times more. The increased level of alcohol consumption can primarily be explained by the lower prices of alcohol in Svalbard. Thus this study strongly confirms the results of other studies which stress the impact of prices on the levels of alcohol consumption.

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Short-term prognostic effect of prior cerebrovascular and peripheral artery disease in patients with acute coronary syndrome: Can we do better?

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872617716388 ◽

2017 ◽

Vol 7 (7) ◽

pp. 652-660 ◽

Cited By ~ 5

Author(s):

Filipa Cordeiro ◽

Pedro S Mateus ◽

Alberto Ferreira ◽

Silvia Leao ◽

Miguel Moz ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Confidence Interval ◽

Hospital Mortality ◽

Odds Ratio ◽

Composite Endpoint ◽

Short Term ◽

Coronary Syndrome ◽

Artery Disease ◽

The Impact ◽

Prior Stroke

Background: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. Methods: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization. Results: 6.3% patients had prior stroke/TIA, 4.2% prior PAD and 1.4% prior stroke/TIA and PAD. Prior stroke/TIA and/or PAD patients were less likely to receive evidence-based medical therapies (dual antiplatelet therapy: stroke/TIA= 88.6%, PAD= 86.6%, stroke/TIA+PAD= 85.7%, none= 92.2%, p<0.001; β-blockers: stroke/TIA= 77.1%, PAD= 72.1%, stroke/TIA+PAD= 71.9%, none= 80.8%, p<0.001; angiotensin-converting enzyme inhibitors/angiotensin receptor blockers: stroke/TIA= 86.3%, PAD= 83.6%, stroke/TIA+PAD= 83.2%, none= 87.1%, p=0.030) and to undergo percutaneous revascularization (stroke/TIA= 52.8%, PAD= 45.6%, stroke/TIA+PAD= 43.7%, none= 67.9%, p<0.001), despite more extensive coronary artery disease (three-vessel disease: stroke/TIA= 29.1%, PAD= 38.3%, stroke/TIA+PAD= 38.3%, none= 20.2%, p<0.001). In a multivariable analysis, prior stroke/TIA+PAD was a predictor of in-hospital mortality (odds ratio= 2.828, 95% confidence interval 1.001–7.990) and prior stroke/TIA (odds ratio= 1.529, 95% confidence interval 1.056–2.211), prior PAD (odds ratio= 1.618, 95% confidence interval 1.034–2.533) and both conditions (odds ratio= 3.736, 95% confidence interval 2.002–6.974) were associated with the composite endpoint. Conclusion: A prior history of stroke/TIA and/or PAD was associated with lower use of medical therapy and coronary revascularization and with worst short-term prognosis. An individualized management may improve their poor prognosis.

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The effects of smoking and alcoholism in acute coronary syndrome

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.180 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

J Correia ◽

V Neto ◽

J Santos ◽

I Pires ◽

L Goncalves ◽

...

Keyword(s):

Hospital Mortality ◽

Alcohol Intake ◽

Mortality Rates ◽

Coronary Syndrome ◽

Significant Difference ◽

Group A ◽

Excessive Alcohol ◽

Group B ◽

Group D ◽

Excessive Alcohol Intake

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Several studies have concluded that smoking increases mortality in patients with coronary disease. On the other hand, a J-shaped dose-effect curve has been used to describe the relationship between alcohol and cardiovascular mortality. According to the majority of studies, a moderate intake of alcohol is associated with a decrease in mortality, while an excessive alcohol intake appears to increase mortality. Aim To evaluate the effect of smoking and excessive alcohol intake in hospital mortality and 1-year mortality in patients hospitalized due to acute coronary syndrome (ACS). Methods A single-centre retrospective study was conducted, with inclusion of all consecutive patients admitted in the Cardiology Department due to ACS. Follow-up started after hospital admission and ended upon hospital death, death within the following 12 months or 12 months after study entry. Patients were divided in two groups: smokers (Group-A) and non-smokers (Group-B), to analyse the effect of smoking in hospital mortality and 1-year mortality. To analyse the effect of excessive alcohol intake, patients were also divided in other two groups: Group-C (excessive drinkers) and Group-D (non-excessive drinkers). Statistical analysis was performed with SPSS and a p value < 0.05 was considered statistically significant. Results 1120 patients (68.9% male, mean age 69.12 ± 12.67 years) were included in this study. 20.5% were smokers and 3.2% had a previous excessive alcohol intake. Between Group-A and Group-B, a statistically significant difference was observed in gender (93.1% male in Group-A vs 62.9% male in Group-B, p = 0.002), but not in age (p = 0.116). Hospital mortality rates in Group-A and Group-B were respectively 6.0% and 8.7% (p = 0.191) and 1-year mortality rates were 3.1% vs 5.1% (p = 0.239). Between Group-C and Group-D, a statistically significant difference was observed in gender (94.4% male in Group-C vs 69.8% male in Group-B, p < 0.001), but not in age (p = 0.730). Hospital mortality rates in Group-C and Group-D were respectively 25% and 9.6% (p = 0.003) and 1-year mortality were 3.8% vs 6.6% (p = 0.577). Conclusions Smoking did not have a positive or negative effect in hospital mortality and 1-year mortality. However, excessive alcohol intake was associated with increased hospital mortality in this population.

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Impact of smoking habit on platelet reactivity in a cohort of patients admitted due to an acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehaa946.1548 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J.C Gomez Polo ◽

D Vivas Balcones ◽

A.L Marcano Fernandez ◽

J Playan Escribano ◽

L.M Lugo Gavidia ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Platelet Function ◽

Platelet Reactivity ◽

Smoking Habit ◽

Tertiary Care ◽

Funding Source ◽

P2y12 Inhibitors ◽

Lower Response ◽

Coronary Syndrome ◽

The Impact

Abstract Background Several pharmacodynamic studies have shown the impact of smoking habit on platelet reactivity; with a reduction on platelet aggregation. Wether this inhibition in platelet reactivity is due to tobacco effects in platelet signaling pathways or due to a pharmacodynamic interaction with antiplatelet therapies is not well stablished. Purpose Our aim was to study the influence of smoking habit in platelet reactivity and in the response to P2Y12 inhibitors. Methods Patients admitted in four tertiary care hospitals due to an acute coronary syndrome that undergone percutaneous coronary intervention (PCI) were consecutively and prospectively recruited. All the patients received dual antiplatelet therapy with aspirin and a P2Y12 inhibitor following current European Guidelines. Platelet function was assessed at day 1 and day 30 post-PCI by VerifyNow P2Y12, VASP (Vasodilator-stimulated phosphoprotein) y MEA (Multiple electrode aggregometry). Results A total of 1000 patients were enrolled, of whom 12 had to be excluded due to inaccurate processing of blood samples. 372 patients (37,6%) had smoking habit. Non-smoking patients showed higher prevalence of high blood pressure [423 (68.7%) vs 196 (52.7%)] and diabetes mellitus [213 (34.6%) vs 81 (21.8%)]. Smoking patients were younger [57.3 (9,6) years old vs 68.4 (11.1)], with higher incidence of acute coronary syndrome with ST segment elevation [184 patients (49,5%) vs 241 (39.1%), p<0,001]. There were no differences in platelet function at day 1. When analysing platelet function 30 days post-PCI, a lower inhibition of platelet reactivity in non-smoking patients as compared with smoking patients was observed in those treated with clopidogrel, with higher prevalence of clopidogrel-resistance in non-smoking patients (VerifyNow, 51,2% prevalence of high platelet reactivity in non-smoking patients vs 34,9% 30 days after PCI, p=0,023). On the other hand, smoking patients that received ticagrelor did not show any differences. Patients with smoking habit treated with prasugrel showed a lower response of borderline statistical significance. Conclusion Smoking habit was associated with a lower response to prasugrel of borderline significance, and with higher response to clopidogrel, according with previous studies suggesting a pharmacodynamics interaction between tobacco use and P2Y12 inhibitors. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Fondo de Investigaciones Sanitarias (FIS)

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mHealth interventions in the management of heart failure, ischaemic heart disease and hypertension: a systematic review and meta-analysis of randomised controlled trials

European Heart Journal ◽

10.1093/ehjci/ehaa946.3507 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Indraratna ◽

D Tardo ◽

J Yu ◽

K Delbaere ◽

M Brodie ◽

...

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Meta Analysis ◽

Funding Source ◽

Smartphone Applications ◽

Coronary Syndrome ◽

Significant Difference ◽

The Impact

Abstract Introduction Cardiovascular disease (CVD) remains the leading cause of death in the world. Mobile phones have become ubiquitous in most developed societies. Smartphone applications, telemonitoring and clinician-driven short message service (SMS) allow for novel methods in managing chronic cardiovascular conditions such as ischaemic heart disease, heart failure and hypertension. Purpose To evaluate the impact of mobile phone-based interventions (MPIs) on mortality, hospitalisations and blood pressure and body mass index (BMI) in patients diagnosed with either acute coronary syndrome, heart failure or hypertension. Methods A systematic review was conducted using seven electronic databases, identifying all randomised control trials (RCTs) featuring an MPI in the management of these conditions. Meta-analysis was performed by using standard analytical techniques. The odds ratio (OR) was used as a summary statistic. Results Twenty-six RCTs including 6,713 patients were identified. Of these 26 studies, 13 examined text messaging intereventions, 10 studied telemonitoring interventions and three described smartphone applications with other functions. Twelve studies were included for meta-analysis. In patients with heart failure (n=1683), MPIs were associated with a significantly lower rate of all-cause hospital admissions at six months (31% vs. 36%, OR 0.77, 95% CI 0.62–0.97, p=0.03, I2 = 0). A significant difference was also demonstrated for heart-failure admissions (14.0% vs. 18.5%, OR 0.69, 95% CI 0.48 to 0.98, p=0.04, I2 = 26%). There was no difference in mortality (10.4% vs. 11.6% p=0.45). In patients with hypertension, the difference in systolic BP was 4.3mmHg less in the intervention group (95% CI: −7.8 to −0.78 mmHg, p=0.02). Four studies examined medication compliance as an endpoint in patients with ischaemic heart disease, and all four demonstrated a significant difference favouring the MPI group (see table 1). However, due to variable quantification of compliance, meta-analysis was not possible. There was no significant difference in the change in BMI from four studies after six or more months (mean difference −0.46, 95% CI: −1.44 to 0.52, P=0.36). Conclusions The available data suggests MPIs may have a role as valuable adjuncts in the management of chronic CVD. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council (NHMRC)

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Alcohol Abstinence and the Risk of Atrial Fibrillation in Patients With Newly Diagnosed Type 2 Diabetes Mellitus: A Nationwide Population-Based Study

10.2337/figshare.13956677.v1 ◽

2021 ◽

Author(s):

You-jung Choi ◽

Kyung-Do Han ◽

Eue-Keun Choi ◽

Jin-Hyeung Jung ◽

So-Ryoung Lee ◽

...

Keyword(s):

Diabetes Mellitus ◽

Atrial Fibrillation ◽

Alcohol Consumption ◽

Alcohol Intake ◽

Newly Diagnosed ◽

Heavy Alcohol ◽

Alcohol Abstinence ◽

Heavy Alcohol Consumption ◽

New Onset

Objectives: To investigate the effects of alcohol abstinence in preventing new-onset atrial fibrillation (AF) in patients with type 2 diabetes mellitus (T2DM). Research Design and Methods: A total of 1,112,682 patients newly diagnosed with T2DM between 2011–2014, were identified from the Korean National Health Insurance Service database. After excluding a previous history of AF, 175,100 subjects were included. The primary outcome was new-onset AF. Results: During a mean follow-up of 4.0 years, AF occurred in 4,174 patients. Heavy alcohol consumption (alcohol intake ≥40 g/day) before a T2DM diagnosis had a higher risk of AF (adjusted hazard ratio [aHR] 1.22, 95% confidence interval [CI] 1.06–1.41) compared to no alcohol consumption. After a T2DM diagnosis, moderate-to-heavy alcohol consumption (alcohol intake ≥20 g/day) who abstained from alcohol had a lower risk of AF (aHR 0.81, 95% CI 0.68–0.97) than did constant drinkers. Alcohol abstinence showed consistent trends toward lower incident AF in all subgroups and was statistically significant in men (aHR 0.80, 95% CI 0.67–0.96), those aged >65 years (aHR 0.69, 95% CI 0.52–0.91), those with CHA2DS2-VASc score <3 points (aHR 0.71, 95% CI 0.59–0.86), non-insulin users (aHR 0.77, 95% CI 0.63–0.94), and body mass index < 25 mg/k2 (aHR 0.68, 95% CI 0.53–0.88). Conclusions: In patients with newly diagnosed T2DM, alcohol abstinence was associated with a low risk of AF development. Lifestyle modifications, such as alcohol abstinence, in patients newly diagnosed with T2DM should be recommended to reduce the risk of AF.

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