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 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 Alcohol consumption behavior and new-onset atrial fibrillation in patients with newly-diagnosed type 2 diabetes mellitus: a nationwide population-based study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y.J Choi ◽  
C.E.K Choi
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Alcohol Consumption ◽  
Continuous Group ◽  
Newly Diagnosed ◽  
Consumption Behavior ◽  
New Onset

Abstract Background Type 2 Diabetes mellitus (T2DM) has a high risk of being associated with cardiovascular diseases including atrial fibrillation (AF). Although excessive alcohol consumption is an established modifiable risk factor for AF, alcohol behavior modification for preventing the risk of AF is not widely studied. Objective We explored the clinical effects of alcohol consumption behavior on the prevention from new-onset AF in patients with T2DM. Methods A total of 180,964 patients newly diagnosed with T2DM were identified between 2009 and 2014 from the Korean National Health Insurance Service database after excluding a previous history of AF. We followed up them until 2017, and compared the risk of AF according to alcohol consumption behavior. Results During follow-up of mean 4.3 years, new-onset AF occurred in 2,386 patients. Compared to non-drinkers, heavy drinker (≥30 g/day) at the baseline had a higher risk of AF (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.112–1.492), whereas mild-drinker had no statically significant difference. According to alcohol consumption behavior, subject who stopped drinking from the time of T2DM diagnosis had the lower risk of AF; abstinence group (HR 1.33, 95% CI 1.135–1.569), restart group (HR 1.38, 95% CI 1.131–1.688) and continuous group (HR 1.48, 95% CI 1.238–1.776). In subgroup analysis, the impact of alcohol consumption behavior was more pronounced in male, but not in female; abstinence group (HR 1.30, 95% CI 1.101–1.536), restart group (HR 1.40, 95% CI 1.141–1.711), and continuous group (HR 1.49, 95% CI 1.244–1.789). Conclusions Abstention from alcohol reduced the risk of AF development in patient newly diagnosed with T2DM. Especially, in men, alcohol consumption behaviour modification is an important strategy for preventing cardiovascular event in patient newly diagnosed with T2DM. Funding Acknowledgement Type of funding source: None

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

Circulation ◽  
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.

scholarly journals Comparative effects of sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors on new-onset atrial fibrillation and stroke outcomes

2021 ◽  
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Carlin Chang ◽  
Tong Liu ◽  
Dong Chang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Lower Risk ◽  
Sglt2 Inhibitors ◽  
All Cause Mortality ◽  
New Onset

AbstractBackgroundSGLT2I and DPP4I are medications prescribed for type 2 diabetes mellitus patients. However, there are few population-based studies comparing their effects on incident atrial fibrillation or ischemic stroke.MethodsThis was a territory-wide cohort study of type 2 diabetes mellitus patients prescribed SGLT2I or DPP4I between January 1st, 2015 to December 31st, 2019 in Hong Kong. Patients with both DPP4I and SGLT2I use and patients with drug discontinuation were excluded. Patients with prior AF or stroke were excluded for the respective analysis. 1:2 propensity-score matching was conducted for demographics, past comorbidities and medications using nearest-neighbor matching method. Cox models were used to identify significant predictors for new onset heart failure (HF) or myocardial infarction (MI), cardiovascular and all-cause mortality.ResultsThe AF-free cohort included 49108 patients (mean age: 66.48 years old [SD: 12.89], 55.32% males) and the stroke-free cohort included 49563 patients (27244 males [54.96%], mean baseline age: 66.7 years old [SD: 12.97, max: 104.6 years old]). After propensity score matching, SGLT2i use was associated with a lower risk of new onset AF (HR: 0.43[0.28, 0.66]), cardiovascular mortality (HR: 0.79[0.58, 1.09]) and all-cause mortality (HR: 0.69[0.60, 0.79]) in the AF-free cohort. It was also associated with a lower risk of new onset stroke (0.46[0.33, 0.64]), cardiovascular mortality (HR: 0.74[0.55, 1.00]) and all-cause mortality (HR: 0.64[0.56, 0.74]) in the stroke-free cohort.ConclusionsThe novelty of our work si that SGLT2 inhibitors are protective against atrial fibrillation and stroke development for the first time. These findings should be validated in other cohorts.

scholarly journals Heavy Alcohol Consumption and Risk of Atrial Fibrillation

2014 ◽  
Vol 78 (4) ◽  
pp. 955-961 ◽  
Author(s):  
Fumihiko Sano ◽  
Tetsuya Ohira ◽  
Akihiko Kitamura ◽  
Hironori Imano ◽  
Renzhe Cui ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Alcohol Consumption ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption

scholarly journals 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 ◽  
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 (&lt;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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