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

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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Abstract P002: Heavy Alcohol Consumption Increases the Risk of Atrial Fibrillation -Circulatory Risk in Communities Study(CIRCS)

Circulation ◽

10.1161/circ.127.suppl_12.ap002 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Fumihiko Sano ◽

Tetsuya Ohira ◽

Akihiko Kitamura ◽

Hironori Imano ◽

Renzhe Cui ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Medical History ◽

Moderate Alcohol Consumption ◽

Heavy Alcohol ◽

Ethanol Drinking ◽

Wide Range ◽

Detailed Medical History ◽

Heavy Alcohol Consumption

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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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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Impact of Blood Pressure Visit‐to‐Visit Variability on Adverse Events in Patients With Nonvalvular Atrial Fibrillation: Subanalysis of the J‐RHYTHM Registry

Journal of the American Heart Association ◽

10.1161/jaha.120.018585 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Eitaro Kodani ◽

Hiroshi Inoue ◽

Hirotsugu Atarashi ◽

Ken Okumura ◽

Takeshi Yamashita ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Adverse Events ◽

Coefficient Of Variation ◽

Adverse Outcomes ◽

Nonvalvular Atrial Fibrillation ◽

Unique Identifier ◽

Major Hemorrhage ◽

Hazard Ratios ◽

Post Hoc

Background Blood pressure (BP) variability has reportedly been a risk factor for various clinical events. To clarify the influence of BP visit‐to‐visit variability on adverse events in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J‐RHYTHM Registry was performed. Methods and Results Of 7406 outpatients with nonvalvular atrial fibrillation from 158 institutions, 7226 (age, 69.7±9.9 years; men, 70.7%), in whom BP was measured 4 times or more (14.6±5.0 times) during the 2‐year follow‐up period or until occurrence of an event, constituted the study group. SD and coefficient of variation of BP values were calculated as BP variability. Thromboembolism, major hemorrhage, and all‐cause death occurred in 110 (1.5%), 121 (1.7%), and 168 (2.3%) patients, respectively. When patients were divided into quartiles of systolic BP‐SD (<8.20, 8.20–10.49, 10.50–13.19, and ≥13.20 mm Hg), hazard ratios (HRs) for all adverse events were significantly high in the highest quartile compared with the lowest quartile (HR, 2.00, 95% CI, 1.15–3.49, P =0.015 for thromboembolism; HR, 2.60, 95% CI, 1.36–4.97, P =0.004 for major hemorrhage; and HR, 1.85, 95% CI, 1.11–3.07, P =0.018 for all‐cause death) after adjusting for components of the CHA 2 DS 2 ‐VASc score, warfarin and antiplatelet use, atrial fibrillation type, BP measurement times, and others. These findings were consistent when BP‐coefficient of variation was used instead of BP‐SD. Conclusions Systolic BP visit‐to‐visit variability was significantly associated with all adverse events in patients with nonvalvular atrial fibrillation. Further studies are needed to clarify the causality between BP variability and adverse outcomes in patients with nonvalvular atrial fibrillation. Registration URL: https://www.umin.ac.jp/ctr/ ; Unique Identifier: UMIN000001569.

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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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Associations Between Smoking, Alcohol Consumption, Physical Activity and Depression in Middle-Aged Premenopausal and Postmenopausal Women

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.761761 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hyewon Kim ◽

Juhwan Yoo ◽

Kyungdo Han ◽

Maurizio Fava ◽

David Mischoulon ◽

...

Keyword(s):

Physical Activity ◽

Alcohol Consumption ◽

Postmenopausal Women ◽

Premenopausal Women ◽

Regular Physical Activity ◽

Health Examination ◽

Middle Aged ◽

Heavy Alcohol ◽

Increased Risk ◽

Heavy Alcohol Consumption

Background: Changes in lifestyle factors are known to affect mood. However, there is insufficient evidence supporting the association between smoking, alcohol consumption, physical activity and depression in middle-aged women who are likely to experience rapid hormonal changes.Methods: We used a nationwide database of medical records in South Korea. 901,721 premenopausal and 943,710 postmenopausal women aged 40 years or older included in this study. Information on smoking, alcohol consumption, physical activity was identified from health examination data and followed up for the occurrence of depression using claims data.Results: Compared with never-smokers, ex-smokers and current smokers among premenopausal and postmenopausal women showed an increased risk of depression in a dose-dependent manner (aHR 1.13 for ex-smokers; aHR 1.23 for current smokers). Compared with non-drinkers, mild drinkers showed a decreased risk of depression (aHR 0.98 for premenopausal women; aHR 0.95 for postmenopausal women), and heavy drinkers showed an increased risk of depression both among premenopausal (aHR 1.20) and postmenopausal women (aHR 1.05). The risk of depression due to smoking and heavy alcohol consumption was higher in premenopausal women than in postmenopausal women. Compared with those who had not engaged in regular physical activity, those who had engaged showed a decreased risk of depression both among premenopausal (aHR 0.96) and postmenopausal women (aHR 0.95).Conclusions: Smoking and heavy alcohol consumption increased the risk of depression, and the increased risk was prominent in premenopausal than in postmenopausal women. Regular physical activity decreased the risk of depression both in premenopausal and postmenopausal women.

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Alcohol consumption and risk of fatty liver disease: a meta-analysis

PeerJ ◽

10.7717/peerj.2633 ◽

2016 ◽

Vol 4 ◽

pp. e2633 ◽

Cited By ~ 14

Author(s):

Guoli Cao ◽

Tingzhuang Yi ◽

Qianqian Liu ◽

Min Wang ◽

Shaohui Tang

Keyword(s):

Liver Disease ◽

Alcohol Consumption ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Meta Analysis ◽

Small Sample ◽

Cross Sectional ◽

Heavy Alcohol ◽

Increased Risk ◽

Heavy Alcohol Consumption

Background Observational studies have shown inconsistent results regarding alcohol consumption and risk of fatty liver. We performed a meta-analysis of published literature to investigate the association between alcohol consumption and fatty liver disease (FLD). Methods We searched Medline, Embase, Web of Science, and several Chinese databases, identifying studies that reported an association between alcohol consumption and the risk of FLD. Results A total of 16 studies with 76,608 participants including 13 cross-sectional studies, two cross-sectional following longitudinal studies, and one cohort study met the inclusion criteria. For light to moderate alcohol consumption (LMAC), there was a 22.6% reduction in risk of FLD (odds ratio [OR] = 0.774, 95% confidence interval CI [0.695–0.862], P <0.001), and subgroup analysis showed that a greater reduction in risk of FLD was found in the female drinkers (30.2%) and the drinkers with BMI ≥25 kg/m2(31.3%) compared with the male drinkers (22.6%) and the drinkers with BMI <25 kg/m2(21.3%), respectively. For heavy alcohol consumption, there was no significant influence on risk of FLD (OR = 0.869, 95% CI [0.553–1.364], P = 0.541) in Japanese women, but there was a 33.7% reduction in risk of FLD (OR = 0.663, 95% CI [0.574–0.765], P < 0.001) in Japanese men and a significant increased risk of FLD (OR = 1.785, 95% CI [1.064–2.996], P = 0.028) in Germans. Conclusion LMAC is associated with a significant protective effect on FLD in the studied population, especially in the women and obese population. However, the effect of heavy alcohol consumption on FLD remains unclear due to limited studies and small sample sizes.

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A Dose-Response Meta-Analysis on the Association Between Alcohol Consumption and Incidence of Atrial Fibrillation

10.21203/rs.3.rs-89496/v1 ◽

2020 ◽

Author(s):

Haifu Zhang ◽

Qinxia Zhang ◽

Dong Yang ◽

Zhao Xu ◽

Xingwei Zhang

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Dose Response ◽

Meta Analysis ◽

Cochrane Library ◽

Response Curves ◽

Female Population ◽

Men And Women ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption

Abstract Background: Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. Alcohol consumption has been linked to the occurrence of AF.Methods: A comprehensive search of electronic databases (PubMed, Cochrane Library, OVID, Google scholar, and Web of Science) was performed. The search yielded a total of 1177 articles, and 12 cohort studies from the total were included in the meta-analysis. The effects of different doses of alcohol consumption on the risk of AF in men and women were compared using hierarchical analysis. Dose-response curves of alcohol consumption and risk of AF were plotted for the two groups according to sex.Results: The risk of AF increased with increased alcohol consumption in both men and women. In the male population, light-moderate alcohol consumption did not increase the risk of AF (HR: 1.07, 95%CI: 0.92-1.23, P=0.38), while heavy alcohol consumption significantly increased the risk of AF (HR: 1.38, 95%CI: 1.23-1.54, P<0.01). In the female population, the risk of AF was not significantly increased by either light-moderate or heavy alcohol consumption (light- moderate drink: HR: 1.00, 95%CI: 0.92-1.10, P=0.95; heavy drink: HR: 1.05, 95%CI: 0.90-1.23, P=0.55).Conclusions: In women, the risk of AF was not associated with any degree of alcohol consumption while high levels of alcohol consumption significantly increased the risk of AF in men.

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OC.10.5 OBESITY AND HEAVY ALCOHOL CONSUMPTION ARE INDEPENDENTLY ASSOCIATED WITH AN INCREASED RISK OF COLORECTAL CANCER: A NESTED CASE-CONTROL STUDY

Digestive and Liver Disease ◽

10.1016/s1590-8658(14)60068-2 ◽

2014 ◽

Vol 46 ◽

pp. S25

Author(s):

M. Fabbri ◽

R.M. Zagari ◽

D. Colussi ◽

N. Garavelli ◽

F. Bazzoli ◽

...

Keyword(s):

Colorectal Cancer ◽

Alcohol Consumption ◽

Case Control Study ◽

Case Control ◽

Heavy Alcohol ◽

Increased Risk ◽

Heavy Alcohol Consumption ◽

Nested Case Control ◽

Control Study

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Combined impact of smoking and heavy alcohol use on cognitive decline in early old age: Whitehall II prospective cohort study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.112.122960 ◽

2013 ◽

Vol 203 (2) ◽

pp. 120-125 ◽

Cited By ~ 30

Author(s):

Gareth Hagger-Johnson ◽

Séverine Sabia ◽

Eric John Brunner ◽

Martin Shipley ◽

Martin Bobak ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Consumption ◽

Cognitive Decline ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Reference Group ◽

Heavy Alcohol ◽

Age Related ◽

Heavy Alcohol Consumption ◽

Combined Impact

BackgroundIdentifying modifiable risk factors for cognitive decline may inform prevention of dementia.AimsTo examine the combined impact of cigarette smoking and heavy alcohol consumption on cognitive decline from midlife.MethodProspective cohort study (Whitehall II cohort) with three clinical examinations in 1997/99, 2002/04 and 2007/09. Participants were 6473 adults (72% men), mean age 55.76 years (s.d. = 6.02) in 1997/99. Four cognitive tests, assessed three times over 10 years, combined into a global z-score (mean 0, s.d. = 1).ResultsAge-related decline in the global cognitive score was faster in individuals who were smoking heavy drinkers than in non-smoking moderate alcohol drinkers (reference group). The interaction term (P = 0.04) suggested that the combined effects of smoking and alcohol consumption were greater than their individual effects. Adjusting for age, gender, education and chronic diseases, 10-year decline in global cognition was −0.42 z-scores (95% Cl −0.45 to −0.39) for the reference group. In individuals who were heavy alcohol drinkers who also smoked the decline was −0.57 z-scores (95% Cl −0.67 to −0.48); 36% faster than the reference group.ConclusionsIndividuals who were smokers who drank alcohol heavily had a 36% faster cognitive decline, equivalent to an age-effect of 2 extra years over 10-year follow-up, compared with individuals who were non-smoking moderate drinkers.

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