Higher Alcohol Consumption Linked to Increased Risk of Atrial Fibrillation

Eue-Keun Choi, MD, PhD

Persistent moderate to heavy drinking and increased cumulative alcohol consumption burden might increase the risk of atrial fibrillation (AF) in young adults, according to new findings.

The data suggest the risk of AF was higher by 25% in individuals who maintained moderate to heavy drinking for 4 years, while persistent heavy drinking across 4 years was associated with a 47% higher risk of AF.

“As the risk of AF and stroke is lowered by alcohol abstinence under various circumstances, young adults should be educated about the risk of AF and its association with drinking,” wrote study author Eue-Keun Choi, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital.

As a modifiable risk factor associated with AF, heavy drinking may be improved with education and awareness. Within a nationwide population-based cohort in Korea, Choi and colleagues investigated the outcomes of a 4-year cumulative burden of alcohol consumption on the risk of incident AF in a population aged 20 to 39 years.

The data were collected from the Korean National Health Information Database (NHID) and included participants without prior AF who underwent 4 serial annual health examinations between 2009 and 2012.

In order to define the cumulative alcohol consumption burden, investigators assigned 1 point to each year of moderate to heavy drinking (>105 g per week).Then, to evaluate the dose-response association between the amount of alcohol consumption and risk of AF, a more stratified scoring for alcohol burden was conducted.

The semiquantitative cumulative burden was calculated by assigning 1, 2, and 3 points for mild, moderate, and heavy drinking (mild drinking, <105g per week; moderate, 105 - 210 g per week; and heavy, ≥210 g per week).

Primary outcomes or the study were the diagnosis of new-onset AF during the follow-up. Investigators analyzed the association between cumulative alcohol burden and the risk of AF using a multivariable Cox regression model.

A total of 1,537,836 participants were included in the final analysis (mean age, 29.5 years; 1,100,099 [71.5%] male).

According to the 4-year cumulative burden stratified by moderate to heavy drinking, there were:

• 889,382 participants (57.8%) in the burden 0 group
• 203,374 participants (13.2%) in the burden 1 group
• 148,087 participants (9.6%) in the burden 2 group
• 144,023 participants (9.4%) in the burden 3 group
• 152 970 participants (9.9%) in the burden 4 group

Over a median follow-up of 6.12 years, atrial fibrillation was newly diagnosed in 3066 participants (0.36 per 1000 person-years). Data show participants with burdens 1 and 3 were associated with a 14% and 16% increased risk of AF compared with the 0 group, respectively.

Individuals with a cumulative burden of 4 points showed a 25% higher risk of AF (adjusted hazard ratio [aHR], 1.25; 95% CI, 1.12 - 1.40) and those who sustained heavy drinking for 4 consecutive years were associated with a 47% higher AF risk (aHR, 1.47; 95% CI, 1.18 - 1.83).

As the worldwide prevalence and incidence of AF continue to increase, investigators noted that “young adults with heavy drinking habits should be educated about the hazardousness of AF and its association with heavy drinking. ”

The study, “Habitual Alcohol Intake and Risk of Atrial Fibrillation in Young Adults in Korea,” was published in JAMA Cardiology.