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HomeHarm ReductionCardiologists warn people with heart rhythm disorders against heavy alcohol

Cardiologists warn people with heart rhythm disorders against heavy alcohol

Fourteen drinks a week is linked with a higher risk of health problems including stroke and embolism in patients with atrial fibrillation, according to research published in EP Europace, a journal of the European Society of Cardiology.

“Our study suggests that atrial fibrillation patients should avoid heavy alcohol consumption to prevent stroke and other complications,” said author Dr Boyoung Joung of Yonsei University College of Medicine in Seoul, Republic of Korea, writes Sophia Antipolis in a report published by the ESC on 2 December 2020.

The study included 9,411 patients with atrial fibrillation from 18 tertiary hospitals covering all geographical regions of South Korea. Patients were categorised into four groups according to their weekly alcohol consumption (one drink contains 14 grams of alcohol): abstainer/rare (0 grams/less than one drink), light (less than 100 grams/7 drinks), moderate (100–200 grams/7–14 drinks), and heavy (200 grams/14 drinks or more).

A total of 7,455 (79.2%) patients were classified as abstainer/rare, 795 (8.4%) as light, 345 (3.7%) as moderate, and 816 (8.7%) as heavy alcohol consumption.

Patients were followed-up for a median of 17.4 months for adverse events, which included stroke, transient ischaemic attack, systemic embolism (a blood clot in a limb or organ), and hospitalisation for rate or rhythm control of atrial fibrillation or for heart failure management.

The researchers recorded how many patients experienced any of these events and calculated the incident rate (number of events per 100 person-years). Incident rates were 6.73, 5.77, 6.44, and 9.65 in the abstainer/rare, light, moderate, and heavy drinkers, respectively.

The researchers compared the risk of adverse events in the light, moderate, and heavy drinkers to the abstainer/rare group. Heavy drinking was associated with a 32% increased risk compared with the abstainers and rare drinkers. No significant association was observed for light or moderate alcohol consumption.

Joung said: “Our study did not find any significant association between light or moderate drinking and complications. A significant deleterious relationship with heavy drinking was identified, suggesting that heavy alcohol consumption should be avoided.”

Subgroup analyses showed that the impact of heavy drinking was more pronounced in patients with low stroke risk compared to those at moderate or high stroke risk. Similarly, heavy drinking was associated with a greater likelihood of unfavourable outcomes in patients without high blood pressure compared to those with high blood pressure. Higher risks were also observed in patients not using beta-blockers or antiplatelet medications compared to those taking the drugs.

Joung said: “The findings indicate that heavy drinking is particularly detrimental for atrial fibrillation patients who are considered less vulnerable to complications. Clinicians should ask patients about their alcohol consumption and take it into account when calculating their stroke risk.”

He concluded: “While heavy drinking should be strongly discouraged among atrial fibrillation patients, moderate drinking seems to be safe.”

 

Effect of alcohol consumption on the risk of adverse events in atrial fibrillation: from the COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry 

EP Europace. Published on 23 November 2020.

Authors

Chewan Lim,  Tae-Hoon Kim,  Hee Tae Yu,  So-Ryoung Lee,  Myung-Jin Cha, Jung-Myung Lee,  Junbeom Park,  Jin-Kyu Park,  Ki-Woon Kang,  Jaemin Shim, Jae-Sun Uhm,  Jun Kim,  Hyung Wook Park,  Eue-Keun Choi,  Jin-Bae Kim, Young Soo Lee and Boyoung Joung

Abstract

The aim of this study is to determine the relationship between alcohol consumption and atrial fibrillation (AF)-related adverse events in the AF population.

Methods and results

A total of 9,411 patients with nonvalvular AF in a prospective observational registry were categorized into four groups according to the amount of alcohol consumption—abstainer-rare, light (<100 g/week), moderate (100–200 g/week), and heavy (≥200 g/week).

Data on adverse events (ischaemic stroke, transient ischaemic attack, systemic embolic event, or AF hospitalisation including for AF rate or rhythm control and heart failure management) were collected for 17.4 ± 7.3 months. A Cox proportional hazard models was performed to calculate hazard ratios (HRs), and propensity score matching was conducted to validate the results.

The heavy alcohol consumption group showed an increased risk of composite adverse outcomes [adjusted hazard ratio (aHR) 1.32, 95% confidence interval (CI) 1.06–1.66] compared with the reference group (abstainer-rare group).

However, no significant increased risk for adverse outcomes was observed in the light (aHR 0.88, 95% CI 0.68–1.13) and moderate (aHR 0.91, 95% CI 0.63–1.33) groups. In subgroup analyses, adverse effect of heavy alcohol consumption was significant, especially among patients with low CHA2DS2-VASc score, without hypertension, and in whom β-blocker were not prescribed.

Conclusion

Our findings suggest that heavy alcohol consumption increases the risk of adverse events in patients with AF, whereas light or moderate alcohol consumption does not.

 

[link url="https://www.escardio.org/The-ESC/Press-Office/Press-releases/Patients-with-heart-rhythm-disorder-warned-against-heavy-alcohol-consumption"]European Society of Cardiology material – Patients with heart rhythm disorders warned against heavy alcohol consumption[/link]

 

[link url="https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euaa340/5998957"]EP Europacearticle – Effect of alcohol consumption on the risk of adverse events in atrial fibrillation: from the Comparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry[/link]

 

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