scholarly journals Lower risk of stroke after alcohol abstinence in patients with incident atrial fibrillation: a nationwide population-based cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S R Lee ◽  
E K Choi ◽  
J H Jung ◽  
K D Han ◽  
S Oh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Alcohol Consumption ◽  
Ischaemic Stroke ◽  
Lower Risk ◽  
Population Based ◽  
Health Examination ◽  
Newly Diagnosed ◽  
Alcohol Abstinence ◽  
Increased Risk ◽  
Before And After

Abstract Background In a recent study, alcohol abstinence reduced the atrial fibrillation (AF) recurrence in patients with AF. However, the relationship between alcohol consumption and incident stroke in patients with AF per se remains unclear. Purpose To evaluate the association between alcohol consumption status (and its changes) after newly diagnosed AF and the risk of ischaemic stroke. Methods Using the Korean nationwide claims and health examination database, we included subjects who were newly diagnosed with AF between 2010 and 2016. Patients were categorized into three groups according to the status of alcohol consumption before and after AF diagnosis: non-drinkers; abstainers from alcohol after AF diagnosis; and current drinkers. The primary outcome was incident ischaemic stroke during follow-up. Results Among a total of 97,869 newly diagnosed AF patients, 51% were non-drinkers, 13% were abstainers, and 36% were current drinkers. After inverse probability of treatment weighting, baseline characteristics of three groups were well-balanced. Compared to current drinkers, abstainers and non-drinkers were associated with a lower risk of ischaemic stroke (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.77–0.96 for abstainers and HR 0.75, 95% CI 0.70–0.81 for non-drinkers, respectively). Amongst current drinkers, there was a dose-response relationship between the amount of alcohol consumption and the risk of ischaemic stroke. Conclusion Current alcohol consumption was associated with an increased risk of ischaemic stroke in patients with newly diagnosed AF, and alcohol abstinence after AF diagnosis could reduce the risk of ischaemic stroke. Lifestyle intervention, including attention to alcohol consumption, should be encouraged as a part of a comprehensive approach to AF management to improve clinical outcomes. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3126
Author(s):  
Jaehyun Lim ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Jin-Hyung Jung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Reduction ◽  
Lower Risk ◽  
Population Based ◽  
Newly Diagnosed ◽  
Incident Dementia ◽  
Before And After ◽  
Korean National Health Insurance ◽  
New Diagnosis ◽  
New Onset

Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using the Korean National Health Insurance Service database, we enrolled a total of 126,555 patients with newly diagnosed AF between 2010 and 2016, who underwent health examinations within two years before and after their diagnosis of AF. The patients were divided into four groups: persistent non-exercisers, exercise starters, exercise quitters, and exercise maintainers. Results: Based on a total of 396,503 person-years of follow-up, 5943 patients were diagnosed with dementia. Compared to persistent non-exercisers, exercise starters (adjusted hazard ratio (aHR) 0.87; 95% confidence interval (CI) 0.81–0.94), and exercise maintainers (aHR 0.66; 95% CI 0.61–0.72) showed a lower risk of incident dementia; however, the risk was similar in exercise quitters (aHR 0.98; 95% CI 0.92–1.05) (p-trend < 0.001). There was a J-shaped relationship between the dose of exercise and the risk of dementia, with the risk reduction maximized at 5–6 times per week of moderate-to-vigorous PA among exercise starters. Conclusion: Patients who initiated or continued regular exercise after diagnosis of AF were associated with a lower risk of dementia than persistent non-exercisers, with no risk reduction associated with exercise cessation. Our findings may provide evidence for the benefit of exercise prescription to patients with new-onset AF to prevent incident dementia regardless of their current exercise status.

Abstract 12385: Past Alcohol Consumption and Incident Atrial Fibrillation

Circulation ◽  
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.

scholarly journals Association between exercise habits and stroke, heart failure, and mortality in Korean patients with incident atrial fibrillation: A nationwide population-based cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (6) ◽  
pp. e1003659
Author(s):  
Hyo-Jeong Ahn ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Jin-Hyung Jung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Population Based ◽  
Health Examination ◽  
Regular Exercise ◽  
Exercise Habits ◽  
Before And After

Background There is a paucity of information about cardiovascular outcomes related to exercise habit change after a new diagnosis of atrial fibrillation (AF). We investigated the association between exercise habits after a new AF diagnosis and ischemic stroke, heart failure (HF), and all-cause death. Methods and findings This is a nationwide population-based cohort study using data from the Korea National Health Insurance Service. A retrospective analysis was performed for 66,692 patients with newly diagnosed AF between 2010 and 2016 who underwent 2 serial health examinations within 2 years before and after their AF diagnosis. Individuals were divided into 4 categories according to performance of regular exercise, which was investigated by a self-reported questionnaire in each health examination, before and after their AF diagnosis: persistent non-exercisers (30.5%), new exercisers (17.8%), exercise dropouts (17.4%), and exercise maintainers (34.2%). The primary outcomes were incidence of ischemic stroke, HF, and all-cause death. Differences in baseline characteristics among groups were balanced considering demographics, comorbidities, medications, lifestyle behaviors, and income status. The risks of the outcomes were computed by weighted Cox proportional hazards models with inverse probability of treatment weighting (IPTW) during a mean follow-up of 3.4 ± 2.0 years. The new exerciser and exercise maintainer groups were associated with a lower risk of HF compared to the persistent non-exerciser group: the hazard ratios (HRs) (95% CIs) were 0.95 (0.90–0.99) and 0.92 (0.88–0.96), respectively (p < 0.001). Also, performing exercise any time before or after AF diagnosis was associated with a lower risk of mortality compared to persistent non-exercising: the HR (95% CI) was 0.82 (0.73–0.91) for new exercisers, 0.83 (0.74–0.93) for exercise dropouts, and 0.61 (0.55–0.67) for exercise maintainers (p < 0.001). For ischemic stroke, the estimates of HRs were 10%–14% lower in patients of the exercise groups, yet differences were statistically insignificant (p = 0.057). Energy expenditure of 1,000–1,499 MET-min/wk (regular moderate exercise 170–240 min/wk) was consistently associated with a lower risk of each outcome based on a subgroup analysis of the new exerciser group. Study limitations include recall bias introduced due to the nature of the self-reported questionnaire and restricted external generalizability to other ethnic groups. Conclusions Initiating or continuing regular exercise after AF diagnosis was associated with lower risks of HF and mortality. The promotion of exercise might reduce the future risk of adverse outcomes in patients with AF.

Alcohol Consumption and Risk of First-Time Venous Thromboembolism in Men and Women

2019 ◽  
Vol 119 (06) ◽  
pp. 962-970 ◽  
Author(s):  
Magdalena Johansson ◽  
Lars Johansson ◽  
Maria Wennberg ◽  
Marcus Lind
Keyword(s):  
Venous Thromboembolism ◽  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Population Based ◽  
Health Examination ◽  
Standard Drink ◽  
Men And Women ◽  
Increased Risk ◽  
The Mean ◽  
First Time

Background The relationship between alcohol intake and risk of venous thromboembolism (VTE) is unclear. Men and women differ in their drinking habits, which may affect a possible association. Objective This article investigates the association between alcohol consumption, alcohol dependence and VTE in the total population as well as in men and women separately. Methods We performed a prospective, population-based cohort study in northern Sweden. Study participants were 108,025 (51% women) persons aged 30 to 60 years who underwent a health examination between 1985 and 2014. We assessed alcohol consumption and defined alcohol dependence using a questionnaire. The outcome was a validated first-time VTE. Results The mean follow-up time was 13.9 years, and 2,054 participants had a first-time VTE. The mean alcohol consumption was 3.5 standard drinks weekly in men and 1.5 in women. Alcohol dependence was found in 10% of men and 3% of women. There was an association between alcohol consumption (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.00–1.03 per standard drink weekly) as well as alcohol dependence (HR, 1.27; 95% CI, 1.06–1.52) and VTE after adjustments. In men, the risk of VTE increased over quartiles of weekly alcohol consumption (p for trend 0.02), with a HR of 1.22 (95% CI, 1.01–1.47) for the highest quartile. Alcohol dependence was associated with VTE in men (HR, 1.30; 95% CI, 1.07–1.59). In women, there were no significant associations. Conclusion High alcohol consumption and alcohol dependence were associated with increased risk of first-time VTE in men, but not in women.

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

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

<b>Objectives:</b> To investigate the effects of alcohol abstinence in preventing new-onset atrial fibrillation (AF) in patients with type 2 diabetes mellitus (T2DM). <p><b>Research Design and Methods:</b> 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.</p> <p><b>Results:</b> 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 CHA<sub>2</sub>DS<sub>2</sub>-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/k<sup>2</sup> (aHR 0.68, 95% CI 0.53–0.88).</p> <p><b>Conclusions</b>: 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.</p>

scholarly journals Association between Atrial Fibrillation, Myocardial Infarction, Heart Failure and Mortality in Patients with Nontuberculous Mycobacterial Infection: a nationwide population-based study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chan Soon Park ◽  
Eue-Keun Choi ◽  
Bongseong Kim ◽  
Kyung-Do Han ◽  
So-Ryoung Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Mycobacterial Infection ◽  
Population Based ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Significant Difference ◽  
Risk Patients ◽  
The Impact

Abstract NTM infection demonstrates an increasing incidence and prevalence. We studied the impact of NTM in cardiovascular events. Using the Korean nationwide database, we included newly diagnosed 1,730 NTM patients between 2005 and 2008 and followed up for new-onset atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), ischemic stroke (IS), and death. Covariates-matched non-NTM subjects (1:5, n = 8,650) were selected and analyzed. Also, NTM infection was classified into indolent or progressive NTM for risk stratification. During 4.16 ± 1.15 years of the follow-up period, AF, MI, HF, IS, and death were newly diagnosed in 87, 125, 121, 162, and 468 patients. In multivariate analysis, NTM group showed an increased risk of AF (hazard ratio [HR] 2.307, 95% confidence interval [CI] 1.560–3.412) and all-cause death (HR 1.751, 95% CI 1.412–2.172) compared to non-NTM subjects, whereas no significant difference in MI (HR 0.868, 95% CI 0.461–1.634), HF (HR 1.259, 95% CI 0.896–2.016), and IS (HR 1.429, 95% CI 0.981–2.080). After stratification, 1,730 NTM patients were stratified into 1,375 (79.5%) indolent NTM group and 355 (20.5%) progressive NTM group. Progressive NTM showed an increased risk of AF and mortality than indolent NTM group. Screening for AF and IS prevention would be appropriate in these high-risk patients.

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

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

<b>Objectives:</b> To investigate the effects of alcohol abstinence in preventing new-onset atrial fibrillation (AF) in patients with type 2 diabetes mellitus (T2DM). <p><b>Research Design and Methods:</b> 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.</p> <p><b>Results:</b> 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 CHA<sub>2</sub>DS<sub>2</sub>-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/k<sup>2</sup> (aHR 0.68, 95% CI 0.53–0.88).</p> <p><b>Conclusions</b>: 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.</p>

scholarly journals Association Between Change in Metabolic Syndrome Status and Risk of Incident Atrial Fibrillation: A Nationwide Population‐Based Study

2021 ◽  
Author(s):  
Seo‐Young Lee ◽  
So‐Ryoung Lee ◽  
Eue‐Keun Choi ◽  
Soonil Kwon ◽  
Seokhun Yang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Large Scale ◽  
Age Groups ◽  
Asian Population ◽  
The Elderly ◽  
Population Based ◽  
Newly Diagnosed ◽  
Healthy Individuals ◽  
Increased Risk

Backgroud There is a paucity of information on whether changes in metabolic syndrome (MetS) status affect the risk of new‐onset atrial fibrillation (AF). We aimed to evaluate whether changes in MetS status and components of MetS affect AF risk using data from a nationwide observational cohort. Methods and Results A total of 7 565 531 adults without prevalent AF (mean age, 47±14 years) who underwent 2 serial health examinations by the Korean National Health Insurance Cooperation were identified. The patients were categorized into 4 groups according to the change in MetS status in serial evaluations, as follows: patients with persistent MetS (n=1 388 850), healthy patients newly diagnosed with MetS in the second evaluation (n=608 158), patients with MetS who were healthy in the second evaluation (n=798 555), and persistently healthy individuals (n=4 769 968). During a mean 7.9‐year follow‐up, incident AF was diagnosed in 139 305 (1.8%) patients. After multivariable adjustment, the AF risk was higher by 31% in the patients with persistent MetS , 26% in the patients with MetS who were healthy in the second evaluation, and 16% in the healthy patients newly diagnosed with MetS in the second evaluation compared with the persistently healthy individuals. Regardless of the MetS component type, the AF risk correlated with changes in the number of components. The risk of AF was strongly correlated with MetS status changes in the young and middle‐age groups (20–39 years and 40–64 years, respectively) than in the elderly group (≥65 years). Conclusions Dynamic changes in MetS status and persistent MetS were associated with an increased risk of AF in a large‐scale Asian population.

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