January 30, 2021
European Heart Journal
TAKE-HOME MESSAGE
This community-based pooled cohort study examined the relationship between alcohol use and incident atrial fibrillation (AF) in 107,845 individuals. Participants had a median alcohol consumption of 3 g/day over a median follow-up of 13.9 years, during which time 5854 developed AF. There was a non-linear, positive association between alcohol consumption and incident AF in a sex- and cohort-stratified Cox regression analysis. No differences were noted by type of alcohol. There was a reduced risk of incident HF in participants who consumed alcohol at lower doses. An examination of cardiac biomarkers did not fully explain the risk.
Based on these results, individuals who consume even 1.2 drinks per day have a higher risk of AF compared with individuals who consume less alcohol. This information is important in counseling individuals about risk of AF and in considering ways to reduce AF.
Abstract
This abstract is available on the publisher’s site.
AIMS
There is inconsistent evidence on the relation of alcohol intake with incident atrial fibrillation (AF), in particular at lower doses. We assessed the association between alcohol consumption, biomarkers, and incident AF across the spectrum of alcohol intake in European cohorts.
METHODS AND RESULTS
In a community-based pooled cohort, we followed 107 845 individuals for the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. We collected information on classical cardiovascular risk factors and incident heart failure (HF) and measured the biomarkers N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I. The median age of individuals was 47.8 years, 48.3% were men. The median alcohol consumption was 3 g/day. N = 5854 individuals developed AF (median follow-up time: 13.9 years). In a sex- and cohort-stratified Cox regression analysis alcohol consumption was non-linearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16, 95% CI 1.11-1.22, P < 0.001. Associations were similar across types of alcohol. In contrast, alcohol consumption at lower doses was associated with reduced risk of incident HF. The association between alcohol consumption and incident AF was neither fully explained by cardiac biomarker concentrations nor by the occurrence of HF.
CONCLUSIONS
In contrast to other cardiovascular diseases such as HF, even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF, which needs to be considered in AF prevention.