Impact of Alcohol Abstinence in Moderate Drinkers With Atrial Fibrillation - Alcohol-AF

Mar 18, 2019
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Author/Summarized by Author:
Anthony A. Bavry, MD, MPH, FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Date Presented:
03/18/2019
Date Updated:
03/18/2019
Original Posted Date:
03/18/2019
References

Contribution To Literature:

The Alcohol-AF trial showed that abstinence from alcohol was beneficial at preventing atrial fibrillation recurrence.

Description:

The goal of the trial was to evaluate abstinence from alcohol compared with usual consumption among patients with atrial fibrillation and moderate alcohol consumption.


Study Design

  • Randomized
  • Parallel

Patients with atrial fibrillation and regular moderate alcohol consumption were randomized to abstinence (n = 70) versus usual consumption (n = 70).

  • Total number of enrollees: 140
  • Duration of follow-up: 6 months
  • Mean patient age: 62 years
  • Percentage female: 13%
  • Percentage with diabetes: 7%

Inclusion criteria:

  • Paroxysmal or persistent atrial fibrillation
  • Average alcohol intake ≥10 drinks per week

Exclusion criteria:

  • Permanent atrial fibrillation
  • Left ventricular ejection fraction <35%
  • Alcohol dependence or psychiatric comorbidity
  • Liver cirrhosis

Other salient features/characteristics:

  • Average alcohol intake approximately 16 drinks per week

Principal Findings:

The co-primary outcome, atrial fibrillation recurrence, occurred in 53% of the abstinence group compared with 73% of the usual consumption group (p = 0.004).

The co-primary outcome, mean atrial fibrillation burden, was 5.6% of the abstinence group compared with 8.2% of the usual consumption group (p = 0.016).

Secondary outcomes:

  • Atrial fibrillation hospitalization: 9% of the abstinence group compared with 20% of the usual consumption group (p = 0.053)
  • Body mass index (BMI) at follow-up: 27.7 kg/m2 in the abstinence group compared with 28.9 kg/m2 in the usual consumption group (p = 0.03)

Interpretation:

Among patients with atrial fibrillation and moderate alcohol consumption, abstinence from alcohol was associated with a reduction in atrial fibrillation recurrence and atrial fibrillation burden. Abstinence was also associated with a reduction in BMI at follow-up. Patients with atrial fibrillation should be counseled on limiting alcohol consumption.

References:

Presented by Dr. Aleksandr Voskoboinik at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019.

Keywords: ACC19, ACC Annual Scientific Session, Alcohol Abstinence, Alcohol Drinking, Arrhythmias, Cardiac, Atrial Fibrillation, Body Mass Index, Ethanol, Primary Prevention


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