One Drink Per Day Increases Risk of AFib 16% in Healthy Patients

Renate Schnabel, MD, MSc

While some previous research suggests a glass of wine per day could improve heart health, new data from a study of more than 100,000 people is sounding the alarm that a single alcoholic drink per day could increase a person's risk of atrial fibrillation.

Results of the study, which was conducted by a team of European researchers, indicate consuming one alcoholic drink per day was associated with a 16% in risk of developing atrial fibrillation.

"To our knowledge, this is the largest study on alcohol consumption and long-term incidence of atrial fibrillation in the community,” said lead investigator Renate Schnabel, a consultant cardiologist at the University Heart and Vascular Center at Hamburg-Eppendorf, in a statement from the European Society of Cardiology. “Previous studies have not had enough power to examine this question, although they have been able to show a relationship between alcohol intake and other heart and blood vessel problems, such as heart attack and heart failure. In our study, we can now demonstrate that even very low regular alcohol consumption may increase the risk of atrial fibrillation.”

With previous research drawing conflicting or uncertain conclusions on the effects of alcohol intake at lower doses and cardiovascular health, Schnabel and a team of colleagues sought to more clearly define relationships between alcohol intake, biomarkers, and incident atrial fibrillation. For their study, investigators obtained data from 5 community-based cohorts from within the Monica Risk, Genetics, Archiving and Monograph (MORGAM) Biomarker for Cardiovascular Risk Assessment across Europe (BiomarCaRE) projects.

In total, investigators identified 107,845 patients with baseline exams between 1982-2010. Investigators excluded 7753 individuals who had a self-reported or physician-diagnosed history of atrial fibrillation or atrial flutter. The remaining 100,092 participants had a median age of 47.8 years, an age range of 24-97 years at baseline, 51.7% were women, and the median follow-up time was 13.9 years. The median alcohol consumption among those included in the study was 3 grams per day and the mean alcohol consumption was 8.7 grams per day.

Drinking patterns were classified as lifelong abstainer, ex-drinker, less than once a week, 1–2, 3–5, and 6–7 days per day week. Investigators noted adjusted analyses accounted for demographics factors and biomarkers including NTproBNP and high-sensitivity troponin 1.

During the follow-up period, 5854 individuals developed atrial fibrillation. In sex- and cohort-stratified Cox regression analysis alcohol consumption as non-linearly and positively associated with incident atrial fibrillation (HR, 1.16; 95% CI, 1.11-1.22; P <.001). In an analysis adjusted for cardiovascular risk factors, one drink per day was associated with an 18% increase in risk of atrial fibrillation (HR, 1.18; 95% CI, 1.12-1.25; P <.001).

Further analysis indicated consuming up to two drinks per day was associated with a 28% increase in risk and consuming more than two but less than four was associated with a 47% increase in risk of developing atrial fibrillation. Investigators pointed out associations between alcohol consumption and incident atrial fibrillation were not fully explained by cardiac biomarker concentrations or by the occurrence of heart failure.

"These findings are important as the regular consumption of alcohol, the 'one glass of wine a day' to protect the heart, as is often recommended for instance in the lay press, should probably no longer be suggested without balancing risks and possible benefits for all heart and blood vessel diseases, including atrial fibrillation,” added Schnabel.

This study, “Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes,” was published in the European Heart Journal.