Alcohol Consumption and Risk of Atrial Fibrillation: A Dose-Response Meta-Analysis of Prospective Studies

Abstract

BackgroundThis study aimed to investigate the dose-response association between alcohol consumption and atrial fibrillation (AF) risk.MethodsPubMed, Embase, Cochrane Library, and Web of Science were systematically searched using keywords related to alcohol and AF from the establishment of databases up to 1 March 2021. Prospective studies examining the impact of alcohol on the risk of AF with hazard ratios (HRs) were included. Restricted cubic spline regression was performed to quantify the dose-response relationship between alcohol consumption and AF risk.ResultsThirteen eligible studies were included in the meta-analysis, with a total of 645,826 participants and 23,079 cases of AF. When compared with non-/seldom-drinkers, the pooled adjusted HRs of AF were 1.30 (95% confidence interval [CI]: 1.20–1.41) and 1.00 (95% CI: 0.96–1.05) for high and low alcohol consumption, respectively. Moderate alcohol intake significantly increased the risk of AF in males (HR, 1.21; 95% CI: 1.10–1.33) but not in females (HR, 1.02; 95% CI: 0.91–1.14). The cubic spline regression analysis illustrated that the risk of AF significantly increased with daily alcohol intake in a Non-linear manner (R2 = 0.64, P = 5.785 × 10−12).ConclusionThis study revealed a Non-linearly positive association between alcohol intake and the risk of AF. Low alcohol intake was not associated with the development of AF, whereas moderate alcohol intake significantly increased the risk of AF in males but not in females. Our meta-analysis highlighted that alcohol consumption should be restricted to a low level to reduce the risk of AF.

Self-reported Alcohol Consumption and Risk of Atrial Fibrillation

“…Persistent and moderate to heavy drinking and higher cumulative alcohol consumption was associated with higher risk of AF. These findings are in line with a recent dose-response meta-analysis on alcohol and risk of AF based on published studies up to and including 2020, which included 645 826 participants of mainly European ancestry and 23 079 cases of AF, which documented increasing risk of AF by increasing alcohol consumption . The results of the current study extend our knowledge on the unfavorable association between alcohol intake and AF toward younger adults, an age group usually not at high risk of AF.…”

Habitual Alcohol Intake and Risk of Atrial Fibrillation in Young Adults in Korea

“…13 Structural changes in atria such as left atrial enlargement 11 and atrial tissue fibrosis 13 have also been proposed as possible pathophysiology. Although some studies [6][7][8]36,37 have already revealed the association of excessive drinking with increased risk of AF, a few studies 38,39 have recently paid…”

“…Structural changes in atria such as left atrial enlargement and atrial tissue fibrosis have also been proposed as possible pathophysiology. Although some studies have already revealed the association of excessive drinking with increased risk of AF, a few studies have recently paid attention to the threshold amount of drinking or drinking habits associated with the risk of AF. On the other hand, although some studies reported cardiovascular-protective association of mild or moderate drinking, each of these studies used different criteria to define the amount of drinking.…”

Alcohol and Atrial Fibrillation

“…The most important results relating alcohol consumption and AF are summarized in Table 1 (Ref. [17,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]).…”

“…A greater susceptibility of men to develop AF in relation to alcohol was also found in the meta-analysis by Yang et al [36] who found that although low alcohol consumption did not affect the risk of AF, moderate alcohol consumption increased it among men (HR = 1.09; 95% CI: 1.07-1.11) but not among women. A meta-analysis by Zhang et al [37] found that moderate and heavy alcohol consumption was significantly associated with the risk of AF among men (HR = 1.21; 95% CI: 1.10-1.33 and HR = 1, respectively, 54; 95% CI: 1.26-1.89), while among women this was only evident with high alcohol consumption (HR = 1.32; 95% CI: 1.10-1.60). In a meta-analysis by Jiang et al [39], the relationship between alcohol consumption and the risk of AF is linear among men, while among women it takes the shape of a "J" curve.…”