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Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.

Abstract

BACKGROUND

Although high alcohol consumption has been associated with increased risk of atrial fibrillation (AF), the role of light to moderate drinking remains unclear.

OBJECTIVES

The study sought to investigate the association between alcohol consumption and AF risk in a prospective study of Swedish men and women and to conduct a meta-analysis of prospective studies to summarize available evidence.

METHODS

We followed 79,019 men and women who, at baseline, were free from AF and had completed a questionnaire about alcohol consumption and other risk factors for chronic diseases. Incident AF cases were ascertained by linkage to the Swedish Inpatient Register. For the meta-analysis, studies were identified by searching PubMed through January 10, 2014, and by reviewing references of pertinent publications. Study-specific relative risks (RRs) were combined using a random effects model.

RESULTS

Over 859,420 person-years of follow-up (1998 to 2009), 7,245 incident AF cases were identified in our own cohort study. The association between alcohol consumption and AF did not differ by sex (p for interaction = 0.74). Compared with current drinkers of <1 drink/week (12 g alcohol/drink), the multivariable RRs of AF were 1.01 (95% confidence interval [CI]: 0.94 to 1.09) for 1 to 6 drinks/week, 1.07 (95% CI: 0.98 to 1.17) for 7 to 14 drinks/week, 1.14 (95% CI: 1.01 to 1.28) for 15 to 21 drinks/week, and 1.39 (95% CI: 1.22 to 1.58) for >21 drinks/week. Results were similar after excluding binge drinkers. In a meta-analysis of 7 prospective studies, including 12,554 AF cases, the RRs were 1.08 (95% CI: 1.06 to 1.10) for 1 drink/day, 1.17 (95% CI: 1.13 to 1.21) for 2 drinks/day, 1.26 (95% CI: 1.19 to 1.33) for 3 drinks/day, 1.36 (95% CI: 1.27 to 1.46) for 4 drinks/day, and 1.47 (95% CI: 1.34 to 1.61) for 5 drinks/day, compared with nondrinkers.

CONCLUSIONS

These findings indicate that alcohol consumption, even at moderate intakes, is a risk factor for atrial fibrillation.

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  • Authors+Show Affiliations

    ,

    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: susanna.larsson@ki.se.

    ,

    Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.

    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

    Source

    MeSH

    Aged
    Aged, 80 and over
    Alcohol Drinking
    Alcoholic Beverages
    Atrial Fibrillation
    Cohort Studies
    Dose-Response Relationship, Drug
    Female
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Prospective Studies
    Risk Factors
    Sweden

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25034065

    Citation

    Larsson, Susanna C., et al. "Alcohol Consumption and Risk of Atrial Fibrillation: a Prospective Study and Dose-response Meta-analysis." Journal of the American College of Cardiology, vol. 64, no. 3, 2014, pp. 281-9.
    Larsson SC, Drca N, Wolk A. Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. J Am Coll Cardiol. 2014;64(3):281-9.
    Larsson, S. C., Drca, N., & Wolk, A. (2014). Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. Journal of the American College of Cardiology, 64(3), pp. 281-9. doi:10.1016/j.jacc.2014.03.048.
    Larsson SC, Drca N, Wolk A. Alcohol Consumption and Risk of Atrial Fibrillation: a Prospective Study and Dose-response Meta-analysis. J Am Coll Cardiol. 2014 Jul 22;64(3):281-9. PubMed PMID: 25034065.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. AU - Larsson,Susanna C, AU - Drca,Nikola, AU - Wolk,Alicja, PY - 2014/01/14/received PY - 2014/03/08/revised PY - 2014/03/11/accepted PY - 2014/7/19/entrez PY - 2014/7/19/pubmed PY - 2014/9/23/medline KW - alcohol KW - atrial fibrillation KW - meta-analysis KW - prospective studies KW - risk factors SP - 281 EP - 9 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 64 IS - 3 N2 - BACKGROUND: Although high alcohol consumption has been associated with increased risk of atrial fibrillation (AF), the role of light to moderate drinking remains unclear. OBJECTIVES: The study sought to investigate the association between alcohol consumption and AF risk in a prospective study of Swedish men and women and to conduct a meta-analysis of prospective studies to summarize available evidence. METHODS: We followed 79,019 men and women who, at baseline, were free from AF and had completed a questionnaire about alcohol consumption and other risk factors for chronic diseases. Incident AF cases were ascertained by linkage to the Swedish Inpatient Register. For the meta-analysis, studies were identified by searching PubMed through January 10, 2014, and by reviewing references of pertinent publications. Study-specific relative risks (RRs) were combined using a random effects model. RESULTS: Over 859,420 person-years of follow-up (1998 to 2009), 7,245 incident AF cases were identified in our own cohort study. The association between alcohol consumption and AF did not differ by sex (p for interaction = 0.74). Compared with current drinkers of <1 drink/week (12 g alcohol/drink), the multivariable RRs of AF were 1.01 (95% confidence interval [CI]: 0.94 to 1.09) for 1 to 6 drinks/week, 1.07 (95% CI: 0.98 to 1.17) for 7 to 14 drinks/week, 1.14 (95% CI: 1.01 to 1.28) for 15 to 21 drinks/week, and 1.39 (95% CI: 1.22 to 1.58) for >21 drinks/week. Results were similar after excluding binge drinkers. In a meta-analysis of 7 prospective studies, including 12,554 AF cases, the RRs were 1.08 (95% CI: 1.06 to 1.10) for 1 drink/day, 1.17 (95% CI: 1.13 to 1.21) for 2 drinks/day, 1.26 (95% CI: 1.19 to 1.33) for 3 drinks/day, 1.36 (95% CI: 1.27 to 1.46) for 4 drinks/day, and 1.47 (95% CI: 1.34 to 1.61) for 5 drinks/day, compared with nondrinkers. CONCLUSIONS: These findings indicate that alcohol consumption, even at moderate intakes, is a risk factor for atrial fibrillation. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/25034065/Alcohol_consumption_and_risk_of_atrial_fibrillation:_a_prospective_study_and_dose_response_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(14)02513-3 DB - PRIME DP - Unbound Medicine ER -