Alcohol Consumption and the Risk of Incident Atrial Fibrillation: A Meta-Analysis

Abstract

Alcohol consumption is a known, modifiable risk factor for incident atrial fibrillation (AF). However, it remains unclear whether the protective effect of moderate alcohol consumption-that has been reported for various cardiovascular diseases also applies to the risk for new-onset AF. The purpose of this meta-analysis was to evaluate the role of different drinking patterns (low: <14 grams/week; moderate: <168 grams/week; and heavy: >168 grams/week) on the risk for incident AF. Major electronic databases were searched for observational cohorts examining the role of different drinking behaviors on the risk for incident AF. We analyzed 16 studies (13,044,007 patients). Incident AF rate was 2.3%. Moderate alcohol consumption significantly reduced the risk for new-onset AF when compared to both abstainers (logOR: −0.20; 95%CI: −0.28–−0.12; I2: 96.71%) and heavy drinkers (logOR: −0.28; 95%CI: −0.37–−0.18; I2: 95.18%). Heavy-drinking pattern compared to low also increased the risk for incident AF (logOR: 0.14; 95%CI: 0.01–0.2; I2: 98.13%). Substantial heterogeneity was noted, with more homogeneous results documented in cohorts with follow-up shorter than five years. Our findings suggest a J-shaped relationship between alcohol consumption and incident AF. Up to 14 drinks per week seem to decrease the risk for developing AF. Because of the substantial heterogeneity observed, no robust conclusion can be drawn. In any case, our results suggest that the association between alcohol consumption and incident AF is far from being a straightforward dose-response effect.

Harmful Impact of Tobacco Smoking and Alcohol Consumption on the Atrial Myocardium

“…In the Women’s Health Study with 34,715 healthy, middle-aged women consumption of more than two drinks per day significantly increased the risk of incident AF, whereas consumption of less than two drinks a day did not [ 213 ]. These findings are supported by a recent meta-analysis suggesting a J-shaped relationship between the amount of alcohol intake and incident AF [ 221 ].…”

“…Numerous large cohort studies have since confirmed an association between alcohol consumption and incident AF [ 210 , 211 , 212 , 213 , 214 , 215 , 216 ]. Meta-analyses give a thorough overview over the extensive literature regarding the association between alcohol and AF [ 216 , 217 , 218 , 219 , 220 , 221 ].…”

Alcohol and Psoriasis for the Dermatologist: Know, Screen, Intervene

“…Alcohol use is associated with increased risk of cardiovascular disease and cardiovascular disease risk factors [37]. The increased cardiovascular risk generally follows a J-shaped dose-dependent relationship with lower risk with moderate consumption of two standard drinks per day [37,38]. This J-shaped dose-dependent relationship can be seen in hypertension, dyslipidaemia, insulin resistance, myocardial infarction (MI), cerebrovascular accident (CVA) and atrial fibrillation (AF) [37,38].…”

“…The increased cardiovascular risk generally follows a J-shaped dose-dependent relationship with lower risk with moderate consumption of two standard drinks per day [37,38]. This J-shaped dose-dependent relationship can be seen in hypertension, dyslipidaemia, insulin resistance, myocardial infarction (MI), cerebrovascular accident (CVA) and atrial fibrillation (AF) [37,38]. The risk of cardiovascular disease including major adverse cardiac events is increased for patients with severe psoriasis [7].…”

“…The risk of AF is higher in patients with severe psoriasis (HR 1.44) with an increased risk of thromboembolic events (HR 1.26) [ 42 ]. AF is well established to be associated with excess alcohol intake [ 38 ]. It is of note that studies on cardiovascular disease and AF in psoriasis did not control for alcohol consumption.…”