Alcohol Consumption and Risk of Atrial Fibrillation

Quick Takes

  • Even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of atrial fibrillation (AF), which needs to be considered in AF prevention.
  • The hazard ratio for incident AF was 1.16 (95% CI, 1.11–1.22) for one drink (12 g) per day (120 ml of wine, 330 ml of beer, or 40 ml of spirits).

Study Questions:

What is the association between alcohol consumption, biomarkers, and incident atrial fibrillation (AF) across the spectrum of alcohol intake in European cohorts?

Methods:

The authors followed a community-based pooled cohort to examine the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. Clinical information was collected regarding cardiovascular risk factors and incident heart failure (HF). N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I were measured.

Results:

A total of 107,845 individuals were followed. The median age of individuals was 47.8 years; 48.3% were men. The median alcohol consumption was 3 g/day. A total of 5,854 individuals developed AF (median follow-up time, 13.9 years). In Cox regression analysis, alcohol consumption was nonlinearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16 (95% confidence interval [CI], 1.11–1.22). 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:

Even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF.

Perspective:

Prior studies have shown that chronic alcohol consumption in significant amounts is strongly associated with increased risk of AF, even when controlling for cardiomyopathy. Other studies suggested that light alcohol consumption may reduce the risk of other cardiovascular diseases, such as coronary artery disease and hypertension. The authors of the present study observed that there was a clear linear increase in AF incidence starting at very low levels of alcohol consumption. They did not find an association by type of alcoholic beverage and AF, but the study was not designed to answer this question specifically. If the findings of the present study are not secondary to confounders, reduction in alcohol consumption may result in significantly lower AF incidence in the population.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Heart Failure and Cardiac Biomarkers

Keywords: Alcohol Drinking, Alcoholic Beverages, Alcoholism, Arrhythmias, Cardiac, Atrial Fibrillation, Beer, Biological Markers, Cardiomyopathies, Heart Failure, Natriuretic Peptide, Brain, Primary Prevention, Risk Factors, Troponin I, Wine


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