Alcohol Abstinence and Risk of Stroke in AF Patients

Quick Takes

  • In a large nationwide cohort of patients with AF, 36% of subjects with newly diagnosed AF remained current drinkers, and 13% stopped drinking after the diagnosis.
  • Even mild to moderate intake of alcohol increased the risk of ischemic stroke compared to nondrinkers, and abstinence from alcohol after the diagnosis of AF was associated with a lower risk of ischemic stroke compared to current drinkers.

Study Questions:

What is the association between alcohol consumption status after newly diagnosed atrial fibrillation (AF) and the risk of ischemic stroke?


The authors analyzed data of AF patients from the Korean nationwide claims and health database. Patients were categorized into three groups according to the status of alcohol consumption before and after AF diagnosis: nondrinkers, abstainers from alcohol after AF diagnosis, and current drinkers. Nondrinkers, abstainers, and current drinkers were compared using incidence rate differences after the inverse probability of treatment weighting (IPTW).


Among a total of 97,869 newly diagnosed AF patients, 51% were nondrinkers, 13% were abstainers, and 36% were current drinkers. During 310,926 person-years of follow-up, 3,120 patients were diagnosed with incident ischemic stroke (10.0 per 1,000 person-years). At 5-year follow-up, abstainers and nondrinkers were associated with a lower risk for stroke than current drinkers (incidence rate differences after IPTW, -2.03 [-3.25, -0.82] for abstainers and 2.98 [-3.81, -2.15] for nondrinkers, per 1,000 person-years, respectively; and incidence rate ratios after IPTW, 0.75 [0.70, 0.81] for nondrinkers and 0.83 [0.74, 0.93] for abstainers, respectively).


Current alcohol consumption was associated with an increased risk of ischemic stroke in patients with newly diagnosed AF, and alcohol abstinence after AF diagnosis could reduce the risk of ischemic stroke.


In the general population, there is a U shape relationship between the risk of stroke and the amount of alcohol consumption. Prior population studies showed that even light to moderate amounts of daily alcohol consumption (12 grams) may increase the risk of AF. The present study extends those observations to hard endpoint of stroke and shows that even small amounts of alcohol may increase the risk of stroke over patients with AF who abstain from alcohol. This has potentially important implications on modifiable risk factors for stroke in AF patients.

Clinical Topics: Arrhythmias and Clinical EP, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Alcohol Abstinence, Alcohol Drinking, Arrhythmias, Cardiac, Atrial Fibrillation, Brain Ischemia, Ethanol, Risk, Secondary Prevention, Stroke, Treatment Outcome, Vascular Diseases

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