Risk Thresholds for Total and Beverage-Specific Alcohol Consumption and Incident Atrial Fibrillation

Tu, Samuel J.; Gallagher, Celine; Elliott, Adrian D.; Linz, Dominik; Pitman, Bradley M.; Hendriks, Jeroen; Lau, Dennis H.; Sanders, Prashanthan; Wong, Christopher X.

doi:10.1016/j.jacep.2021.05.013

Cited by 43 publications

(47 citation statements)

References 29 publications

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“…From this point, AF risk indicated an almost linear dose-dependent relationship toward every additional consumption of 8 g alcohol per day. 37 However, these results contrast to a recent report of approximately 100,000 individuals pooled from different European cohorts suggesting a curvilinear relationship and increase in AF risk from very low alcohol levels. 38 Differences in sociocultural alcohol consumption patterns, ethnic-specific effects, or other residual confounders may explain the different results of these recent studies (Table 1).…”

Section: Binge Drinking and Holiday Heart Syndromecontrasting

confidence: 91%

Mechanisms and Therapeutic Opportunities in Atrial Fibrillation in Relationship to Alcohol Use and Abuse

Linz

Hertel

Jespersen

et al. 2022

Canadian Journal of Cardiology

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Section: Binge Drinking and Holiday Heart Syndromecontrasting

confidence: 91%

Mechanisms and Therapeutic Opportunities in Atrial Fibrillation in Relationship to Alcohol Use and Abuse

Linz

Hertel

Jespersen

et al. 2022

Canadian Journal of Cardiology

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“…More recently, using data from 249,496 participants, a meta-analysis concluded that there was no increase in risk for AF for consumption of 6-7 drinks (10-12 g per drink) per week [63]. Another large cohort study of 403,281 participants from the UK Biobank with 21,312 incident cases of AF reported a J-shaped relationship for average alcohol consumption, with people drinking 56 g per week or less having the lowest risk in comparison to lifetime abstainers [67]. A beverage-specific analysis showed that the J-shaped curve was found in wine drinkers, but not in beer or spirit drinkers [67].…”

Section: Af and Cardiomyopathymentioning

confidence: 99%

“…Another large cohort study of 403,281 participants from the UK Biobank with 21,312 incident cases of AF reported a J-shaped relationship for average alcohol consumption, with people drinking 56 g per week or less having the lowest risk in comparison to lifetime abstainers [67]. A beverage-specific analysis showed that the J-shaped curve was found in wine drinkers, but not in beer or spirit drinkers [67]. A recent randomized controlled trial indicates that a reduction in drinking is associated with a lower recurrence of AF [81].…”

Section: Af and Cardiomyopathymentioning

confidence: 99%

Alcohol’s Impact on the Cardiovascular System

Roerecke

2021

Nutrients

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Alcohol consumption has been shown to have complex, and sometimes paradoxical, associations with cardiovascular diseases (CVDs). Several hundred epidemiological studies on this topic have been published in recent decades. In this narrative review, the epidemiological evidence will be examined for the associations between alcohol consumption, including average alcohol consumption, drinking patterns, and alcohol use disorders, and CVDs, including ischaemic heart disease, stroke, hypertension, atrial fibrillation, cardiomyopathy, and heart failure. Methodological shortcomings, such as exposure classification and measurement, reference groups, and confounding variables (measured or unmeasured) are discussed. Based on systematic reviews and meta-analyses, the evidence seems to indicate non-linear relationships with many CVDs. Large-scale longitudinal epidemiological studies with multiple detailed exposure and outcome measurements, and the extensive assessment of genetic and confounding variables, are necessary to elucidate these associations further. Conflicting associations depending on the exposure measurement and CVD outcome are hard to reconcile, and make clinical and public health recommendations difficult. Furthermore, the impact of alcohol on other health outcomes needs to be taken into account. For people who drink alcohol, the less alcohol consumed the better.

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“… 3 , 4 Furthermore, abstinence from alcohol after a new diagnosis of AF was associated with a 14% reduction in stroke compared with continued drinking in a population-based study from Korea. 5 So, alcohol and AF seem to have an atypical relationship 6 , 7 vs. other cardiovascular disorders.…”

Section: Public Health and Societal Issues Matter In Atrial Fibrillationmentioning

confidence: 98%

“… 57 Alcohol does not protect from AF no matter dose or type of alcohol (Csengeri study), 3 although the latter is at variance with another recent BIOBANK study. 7 Stopping consuming alcohol after detection of AF may reduce stroke; 5 it may also reduce the recurrence of AF after ablation. 6 Less AF 24 , 25 and stroke 25 was also seen with higher levels of physical activity (PA) as measured by modern day monitoring technology (#) in LOOP trial 24 and UK Biobank.…”

mentioning

confidence: 99%

The year in cardiovascular medicine 2021: arrhythmias

Crijns

Sanders

Albert

et al. 2022

European Heart Journal

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Graphical Abstract Graphical Abstract Randomized trials reported on food supplements to prevent atrial fibrillation (AF), 1 screening for AF, 22 and left atrial appendage occlusion 41 to prevent stroke and novel pacing strategies to prevent death in heart failure patients 33 or syncope recurrence. 35 In RATE-AF, digoxin was superior to bisoprolol, 27 illustrating an old drug can be effective if wisely applied with a patient-oriented endpoint. To improve the impact of primary prevention ICD, the MADIT-ICD benefit score balances the risk of sudden cardiac death and the competing risk of non-arrhythmic death 50 (calculator at https://redcap.urmc.rochester.edu/redcap/surveys/index.php?s=3H888TJ8N7 ). The worldwide differences in ICD usage 56 further support a unified approach focusing on ICD benefits. Contrary to current guidelines, the EAST-AFNET4 substudy suggests that (early) rhythm control benefits asymptomatic and symptomatic patients alike concerning cardiovascular endpoints. 57 Alcohol does not protect from AF no matter dose or type of alcohol (Csengeri study), 3 although the latter is at variance with another recent BIOBANK study. 7 Stopping consuming alcohol after detection of AF may reduce stroke; 5 it may also reduce the recurrence of AF after ablation. 6 Less AF 24 , 25 and stroke 25 was also seen with higher levels of physical activity (PA) as measured by modern day monitoring technology (#) in LOOP trial 24 and UK Biobank. 25 Also from the UK Biobank: long-term night shift work may cause AF. 8

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Risk Thresholds for Total and Beverage-Specific Alcohol Consumption and Incident Atrial Fibrillation

Cited by 43 publications

References 29 publications

Mechanisms and Therapeutic Opportunities in Atrial Fibrillation in Relationship to Alcohol Use and Abuse

Mechanisms and Therapeutic Opportunities in Atrial Fibrillation in Relationship to Alcohol Use and Abuse

Alcohol’s Impact on the Cardiovascular System

The year in cardiovascular medicine 2021: arrhythmias

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