Genetically determined tobacco and alcohol use and risk of atrial fibrillation

Abstract Background The causality between the use of alcohol and cigarettes and atrial fibrillation (AF) remains controversial. We conducted a Mendelian randomization (MR) study to evaluate the association of genetic variants related to tobacco and alcohol use with AF. Methods Single nucleotide polymorphisms (SNPs) related to smoking initiation (N = 374), age at initiation of regular smoking (N = 10), cigarettes per day (N = 55), and smoking cessation (N = 24) were derived from a genome-wide association studies (GWAS) of tobacco use (N = 1.2 million individuals). SNPs related to heavy alcohol use (N = 6) were derived from a GWAS of UK biobank (N = 125,249 individuals). The genetically matching instrumented variables were obtained from the GWAS of AF (N = 588,190 individuals). The estimates between tobacco and alcohol use and AF were combined by inverse-variance weighted (IVW), simple median, weighted median, MR-robust adjusted profile score method, MR-PRESSO, and multivariable MR. Results A total of 65,446 AF patients and 522,744 referents were included. In the IVW analysis, the odds ratio per one-unit increase of smoking initiation was 1.11 (95% CI, 1.06–1.16; P = 3.35 × 10−6) for AF. Genetically predicted age at initiation of regular smoking, cigarettes per day and smoking cessation were not associated with AF. The IVW estimate showed that heavy alcohol consumption increased AF risk (OR, 1.11; 95% CI, 1.04–1.18; P = 0.001). The results were consistent in complementary analyses and multivariable MR. Conclusion Our MR study indicated that regular smoking was associated with increased risk of AF, no matter the age at initiation of regular smoking, or the number of cigarettes smoked per day. Genetically predicted heavy alcohol consumption increased the risk of AF.

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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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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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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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Prevalence of alcohol use among women of reproductive age in Canada

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.41.9.04 ◽

2021 ◽

Vol 41 (9) ◽

pp. 267-271

Author(s):

Mélanie Varin ◽

Elia Palladino ◽

Kate Hill MacaEachern ◽

Lisa Belzak ◽

Melissa M. Baker

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Health Care Providers ◽

Alcohol Exposure ◽

Reproductive Age ◽

Sociodemographic Characteristics ◽

Care Providers ◽

Women Of Reproductive Age ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption

Introduction Reporting on alcohol use among women of reproductive age in Canada addresses a major gap in evidence. Methods We assessed the prevalence of weekly and heavy alcohol consumption among women aged 15 to 54 years by sociodemographic characteristics, province of residence and concurrent use of other substance(s) using data from the 2019 Canadian Community Health Survey. Results Of the target population, 30.5% reported weekly and 18.3% reported heavy alcohol consumption in the past year. Prevalence varied by sociodemographic characteristics, province and substance use. The most notable and significant differences were to do with cannabis use and smoking. Conclusion This information can guide health care providers in assessing alcohol consumption and in promoting low-risk alcohol drinking to prevent alcohol exposure during pregnancy.

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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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Alcohol Use Intensity Decreases in Response to Successful Smoking Cessation Therapy

Genes ◽

10.3390/genes13010002 ◽

2021 ◽

Vol 13 (1) ◽

pp. 2

Author(s):

Robert Philibert ◽

Kelsey Dawes ◽

Willem Philibert ◽

Allan M. Andersen ◽

Eric A. Hoffman

Keyword(s):

Smoking Cessation ◽

Alcohol Consumption ◽

Alcohol Use ◽

Contingency Management ◽

Smoking Intensity ◽

Quit Smoking ◽

Heavy Alcohol Consumption ◽

Highly Correlated ◽

The Relationship ◽

Smoking Cessation Therapy

Smokers frequently drink heavily. However, the effectiveness of smoking cessation therapy for those with comorbid alcohol abuse is unclear, and the content of smoking cessation programs often does not address comorbid alcohol consumption. In order to achieve a better understanding of the relationship between changes in rate of smoking to the change in intensity of alcohol consumption, and the necessity for alcohol-specific programming for dual users, we quantified cigarette and alcohol consumption in 39 subjects undergoing a 3-month contingency management smoking cessation program using recently developed DNA methylation tools. Intake alcohol consumption, as quantified by the Alcohol T Score (ATS), was highly correlated with cg05575921 smoking intensity (adjusted R2 = 0.49) with 19 of the 39 subjects having ATS scores indicative of Heavy Alcohol Consumption. After 90 days of smoking cessation therapy, ATS values decreased with the change in ATS score being highly correlated with change in cg05575921 smoking intensity (adjusted R2 = 0.60), regardless of whether or not the subject managed to completely quit smoking. We conclude that alcohol consumption significantly decreases in response to successful smoking cessation. Further studies to determine whether targeted therapy focused on comorbid alcohol use increases the success of smoking cessation in those with dual use should be explored.

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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 ◽

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

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Predictors of Symptom Course in Alcohol Use Disorder

10.31234/osf.io/xuvaz ◽

2020 ◽

Author(s):

William Conlin ◽

Kenneth J. Sher ◽

Alvaro Vergés ◽

Michaela Hoffman ◽

Douglas Steinley

Keyword(s):

Family History ◽

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Heavy Drinking ◽

Epidemiological Survey ◽

Future Research ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption ◽

History Of

Objective: Alcohol Use Disorder (AUD) has traditionally been viewed as a chronic, progressive, relapsing disorder (Jellinek, 1960; National Institute on Drug Abuse, 2018). However, little is known about the course of individual AUD criteria. To the extent that individual symptoms represent the focus of some treatments (e.g., withdrawal, craving), understanding the course of specific symptoms, and individual differences in symptom course, can inform treatment efforts and future research directions.Method: The current study examined 34,653 participants form Wave 1 (2001-2002) and Wave 2 (2003-2004) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; Grant, Moore, & Kaplan, 2003; Grant, Kaplan, and Stinson, 2005), using logistic regression to analyze the extent to which AUD symptom course is predicted by heavy alcohol consumption, family history of alcoholism, and lifetime diagnosis of Conduct Disorder. Results: The course of all AUD symptoms was significantly influenced by all four external criteria, with the magnitude of the prediction varying across different symptoms and different aspects of course. Conclusion: The strength of the relationship appeared to be related to the theoretical proximity of a given predictor to AUD symptomatology, with heavy drinking being the strongest and family history of AUD being the weakest. The course of all AUD symptoms was strongly associated with the prevalence of the given symptom in the overall sample. Future work should include examining the interchangeability of AUD symptoms and considering heavy alcohol consumption as a criterion for AUD diagnosis.

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Alcohol use and risk of intracerebral hemorrhage

Neurology ◽

10.1212/wnl.0000000000003952 ◽

2017 ◽

Vol 88 (21) ◽

pp. 2043-2051 ◽

Cited By ~ 20

Author(s):

Ching-Jen Chen ◽

W. Mark Brown ◽

Charles J. Moomaw ◽

Carl D. Langefeld ◽

Jennifer Osborne ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Intracerebral Hemorrhage ◽

Reference Group ◽

Strong Association ◽

Moderate Alcohol Consumption ◽

Protective Effects ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption ◽

Race Ethnicity

Objective:To analyze the dose–risk relationship for alcohol consumption and intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study.Methods:ERICH is a multicenter, prospective, case-control study, designed to recruit 1,000 non-Hispanic white patients, 1,000 non-Hispanic black patients, and 1,000 Hispanic patients with ICH. Cases were matched 1:1 to ICH-free controls by age, sex, race/ethnicity, and geographic area. Comprehensive interviews included questions regarding alcohol consumption. Patterns of alcohol consumption were categorized as none, rare (<1 drink per month), moderate (≥1 drink per month and ≤2 drinks per day), intermediate (>2 drinks per day and <5 drinks per day), and heavy (≥5 drinks per day). ICH risk was calculated using the no-alcohol use category as the reference group.Results:Multivariable analyses demonstrated an ordinal trend for alcohol consumption: rare (odds ratio [OR] 0.57, p < 0.0001), moderate (OR 0.65, p < 0.0001), intermediate (OR 0.82, p = 0.2666), and heavy alcohol consumption (OR 1.77, p = 0.0003). Subgroup analyses demonstrated an association of rare and moderate alcohol consumption with decreased risk of both lobar and nonlobar ICH. Heavy alcohol consumption demonstrated a strong association with increased nonlobar ICH risk (OR 2.04, p = 0.0003). Heavy alcohol consumption was associated with significant increase in nonlobar ICH risk in black (OR 2.34, p = 0.0140) and Hispanic participants (OR 12.32, p < 0.0001). A similar association was not found in white participants.Conclusions:This study demonstrated potential protective effects of rare and moderate alcohol consumption on ICH risk. Heavy alcohol consumption was associated with increased ICH risk. Race/ethnicity was a significant factor in alcohol-associated ICH risk; heavy alcohol consumption in black and Hispanic participants poses significant nonlobar ICH risk.

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