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

PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0185228 ◽  
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

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

PLoS ONE ◽  
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

scholarly journals Association of Atrial Fibrillation With Incidence of Extracranial Systemic Embolic Events: The ARIC Study

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Mengyuan Shi ◽  
Lin Y. Chen ◽  
Wobo Bekwelem ◽  
Faye L. Norby ◽  
Elsayed Z. Soliman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Hospital Discharges ◽  
Atherosclerosis Risk In Communities ◽  
Entire Cohort ◽  
Point Increase ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

Background Atrial fibrillation (AF) increases the risk of stroke and extracranial systemic embolic events (SEEs), but little is known about the magnitude of the association of AF with SEE. Methods and Results This analysis included 14 941 participants of the ARIC (Atherosclerosis Risk in Communities) study (mean age, 54.2±5.8, 55% women, 74% White) without AF at baseline (1987–1989) followed through 2017. AF was identified from study ECGs, hospital discharges, and death certificates, while SEEs were ascertained from hospital discharges. CHA 2 DS 2 ‐VASc was calculated at the time of AF diagnosis. Cox regression was used to estimate associations of incident AF with SEE risk in the entire cohort, and between CHA 2 DS 2 ‐VASc score and SEE risk in those with AF. Among eligible participants, 3114 participants developed AF and 270 had an SEE (59 events in AF). Incident AF was associated with increased risk of SEE (hazard ratio [HR], 3.58; 95% CI, 2.57–5.00), after adjusting for covariates. The association of incident AF with SEE was stronger in women (HR, 5.26; 95% CI, 3.28–8.44) than in men (HR, 2.68; 95% CI, 1.66–4.32). In those with AF, higher CHA 2 DS 2 ‐VASc score was associated with increased SEE risk (HR per 1‐point increase, 1.24; 95% CI, 1.05–1.47). Conclusions AF is associated with more than a tripling of the risk of SEE, with a stronger association in women than in men. CHA 2 DS 2 ‐VASc is associated with SEE risk in AF patients, highlighting the value of the score to predict adverse outcomes and guide treatment decisions in people with AF.

Abstract P004: Impact of Atrial Fibrillation on Healthcare Utilization in the Community: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lindsay G Smith ◽  
Pamela L Lutsey ◽  
Laura R Loehr ◽  
Anna Kucharska-Newton ◽  
Lin Y Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Healthcare Utilization ◽  
Fee For Service ◽  
Atherosclerosis Risk In Communities ◽  
Cardiovascular Comorbidities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Adjusted Rate ◽  
Aric Study ◽  
The Impact

Background: Atrial fibrillation (AF) is associated with increased risk of hospitalization. However, little is known about the impact of AF on non-inpatient healthcare utilization or about sex or race differences in AF-related utilization. We examined rates of inpatient and outpatient utilization by AF status in the Atherosclerosis Risk in Communities (ARIC) study. Methods and Results: ARIC cohort participants with incident AF enrolled in fee-for-service Medicare, Parts A and B, for at least 12 continuous months between 1991 and 2009 were matched on age, sex, race and center to up to three participants without AF. Healthcare utilization was ascertained from inpatient and outpatient Medicare claims and classified based on primary ICD-9 code. The analysis included 944 AF and 2,761 non-AF participants. The average number of days hospitalized per year was 13.1 (95% confidence interval [CI]: 11.5-15.0) and 2.8 (95% CI: 2.5-3.1) for those with and without AF, respectively. The corresponding number of outpatient claims per year was 53.2 (95% CI: 50.4-56.1) and 23.0 (95% CI: 22.2-23.8) for those with and without AF, respectively (Table). Most utilization in AF patients was attributable to non-AF conditions, particularly other-cardiovascular disease (CVD)-related reasons; the adjusted rate ratio for days hospitalized per year for other-CVD-related reasons was 4.76 (95% CI: 3.51 - 6.44) for those with compared to those without AF. There was suggestive evidence that sex modified the association between AF and inpatient utilization, with AF related to greater utilization in women than men. The association between AF and healthcare utilization was similar in whites and blacks. Conclusions: This study highlights the considerably greater healthcare utilization (inpatient and outpatient) among those with AF; the differential in utilization due to other-CVD-related reasons was substantial. In addition to recommended heart rate or rhythm treatment, accompanying cardiovascular comorbidities should be evaluated and managed.

Abstract P003: Trajectories of Cardiovascular Risk Factors / Outcomes and Atrial Fibrillation in a 25 Year Follow-up: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Faye L Lopez ◽  
Sunil K Agarwal ◽  
Elsayed Z Soliman ◽  
Lin Y Chen ◽  
Lindsay G Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Index Date ◽  
Reference Group ◽  
Large Population ◽  
Population Based ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Little attention has been devoted to the timing of risk factor development in relation to atrial fibrillation (AF) diagnosis. We assessed the long term trajectories of risk factors and cardiovascular (CV) outcomes in the Atherosclerosis Risk in Communities (ARIC) study, a US community-based cohort. Methods: Our analysis included 2134 individuals with incident AF and 5674 controls matched with cases 1:3 on age, sex, race and center, participating in the ARIC study. Information on incident AF and risk factors / CV outcomes (obesity, hypertension, smoking, diabetes, heart failure (HF), myocardial infarction (MI), and stroke) was obtained during 5 study exams between 1987 and 2013, and surveillance of CV events through 2010. The prevalence of risk factors / CV outcomes in the period before and after the diagnosis of AF (and the corresponding index date for controls) was modeled using general estimating equations models. Adjusted odds ratios (OR) of risk factors / CV outcomes were calculated, using the index date ±2.5 years as the reference group. The interaction of time with AF was used to compare differences in trajectories. Results: During a median follow-up of 24 years, we observed diverse trajectories in the prevalence of risk factors and CV outcomes among AF patients, with steep increases in the prevalence of stroke, MI and HF during the period close to AF diagnosis, while trajectories for hypertension and diabetes showed monotonic increases, and those for smoking and obesity suggested decreases in prevalence after AF diagnosis (Figure A). The trajectories over time for hypertension, obesity, HF, stroke and MI were significantly different based on AF status, with lower increments among those without AF (Figure A and B). Conclusion: In this large population-based study, trajectories in the odds of risk factors and CV outcomes were diverse, suggesting they could have different roles in the pathogenesis of AF. The prevalence of CV outcomes increased after AF diagnosis, and trajectories differed by AF status.

Abstract P026: The Association between Alcohol Consumption and Risk of Heart Failure may be Modified by Sex - the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Alexandra Gonçalves ◽  
Pardeep S Jhund ◽  
Brian Claggett ◽  
Wayne Rosamond ◽  
Anita Deswal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Smoking Status ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Risk Of Death ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

Introduction: Alcohol is a known cardiac toxin, yet the nature of the association between alcohol consumption and the development of heart failure (HF) in the community, and whether this relationship is different in men and women, is unclear. Therefore we assessed the association between alcohol intake and the development of HF or death in men and women in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: We examined 14,993 participants in ARIC without prevalent HF at baseline (1987-89) who were followed through 2009 (median of 20.6 years). Self-reported alcohol consumption was defined as the number of drinks per day (1 drink=14g of alcohol). Using Cox proportional hazards models, we examined the association of alcohol intake with the composite outcome of death or hospitalization for HF, stratified by sex, adjusting for age, diabetes, hypertension, coronary heart disease, body mass index, total cholesterol, physical activity, education level, smoking status, and incident myocardial infarction as a time varying covariate. Results: The risk for HF or death in men was lowest among those who consumed 0-1 drink/day (HR 0.81, 95% CI, 0.72-0.90) compared with those who did not consume alcohol. In contrast, in women the risk associated with consuming 1 or 2 drinks/day was not significantly different from the non-drinkers (0-1 drink HR 1.03, 95% CI 0.89-1.20; 1-2 drinks, HR 1.09, 95% CI 0.81-1.46, P for interaction by sex 0.01). Drinking ≥3 drinks/day increased the risk of HF or death by 40% in men (HR 1.44, 95% CI 1.20-1.72) but more than doubled the risk in women (HR 2.44, 95% CI 1.34-4.47). Conclusion: Consumption of ≥3 alcoholic drinks/day is associated with increased risk for death/HF in both men and women, with a higher risk in women, even adjusting for body size and other covariates. Compared to alcohol abstinence, low alcohol consumption was associated with a lower risk of death/HF in men but not in women. These findings suggest that the toxic and protective effects of alcohol may be different in men and women.

scholarly journals Preventing alcohol use among adolescents: Assessment of the "Alcohol-Free" programme

2018 ◽  
Vol 18 (2) ◽  
pp. 133-141
Author(s):  
Cristina Sá ◽  
Vânia Rocha ◽  
José Cunha Machado ◽  
José Precioso
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Basic Education ◽  
Self Report ◽  
Control Group ◽  
Programme Implementation ◽  
Before And After ◽  
Quasi Experimental ◽  
Prevention Programmes ◽  
Experimental Group

Introduction: Alcohol use among adolescents is associated with serious health problems and with increased mortality. Objectives: This study aimed to assess the efficacy of the "Alcohol-free" programme in the prevention of alcohol consumption among adolescents. Methodology: A quasi-experimental study was conducted including an experimental group of 92 students and a control group of 77 students, who attended the 3rd cycle of basic education at Braga and Porto schools (Portugal). A self-report questionnaire was administered to both groups before and after the programme implementation. The programme was only administered to the experimental group. Results: The “Alcohol-Free” programme may have facilitated the prevention of early alcohol experimentation among adolescents who had never consumed alcohol. The programme may have also helped to reinforce the participants’ intention not to drink alcohol in the future and to prevent increasing drunkenness prevalence among the experimental group. No significant differences were found on the adolescents’ current alcohol consumption and on their knowledge regarding alcohol use. Conclusions: This study contributes to improve future school-based prevention programmes, which should include families, peers and the school community.

Sibling Alcohol Use Disorder Is Associated With Increased Risk for Suicide Attempt

2021 ◽  
pp. 216770262110250
Author(s):  
Mallory E. Stephenson ◽  
Sara Larsson Lönn ◽  
Jessica E. Salvatore ◽  
Jan Sundquist ◽  
Kenneth S. Kendler ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Suicide Attempt ◽  
Alcohol Use Disorder ◽  
Cox Regression ◽  
Population Based ◽  
Swedish Population ◽  
Sibling Pairs ◽  
Increased Risk ◽  
Using Data ◽  
Shared Genetic

The association between having a sibling diagnosed with alcohol use disorder (AUD) and risk for suicide attempt may be attributable to shared genetic liability between AUD and suicidal behavior, effects of environmental exposure to a sibling’s AUD, or both. To distinguish between these alternatives, we conducted a series of Cox regression models using data derived from Swedish population-based registers with national coverage. Among full sibling pairs (656,807 males and 607,096 females), we found that, even after we accounted for the proband’s AUD status, the proband’s risk for suicide attempt was significantly elevated when the proband’s sibling was affected by AUD. Furthermore, the proband’s risk for suicide attempt was consistently higher when the sibling’s AUD registration had occurred more recently. Our findings provide evidence for exposure to sibling AUD as an environmental risk factor for suicide attempt and suggest that clinical outreach may be warranted following a sibling’s diagnosis with AUD.

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.

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