Alcohol consumption and atrial fibrillation risk: An updated dose-response meta-analysis of over 10 million participants

Abstract

BackgroundThe treatment of atrial fibrillation (AF) has made significant progress, but the prevention of AF has not received the attention it deserves. A few recent large-sized studies have conducted dose response analysis and reported different conclusions from previous studies on alcohol consumption and AF risk.ObjectivesThe aim of this study is to examine the potential non-linear association between alcohol consumption and risk of AF and explore the potential differences of gender.MethodsIn this updated dose-response meta-analysis, PubMed, Embase and Cochrane databases were searched until June 2022. Risk estimates were reported as relative risk (RR) with 95% confidence intervals (CIs). The random-effects restricted cubic spline models are used to evaluate the potential non-linear association between alcohol consumption and AF risk.ResultsA total of 10,151,366 participants with 214,365 cases of AF enrolled in 13 prospective studies. The overall meta-analysis showed that a 1 drink/day increase in alcohol consumption increased the risk of AF by 6% (RR: 1.06; 95% CI: 1.03–1.08). In gender subgroup analysis, pooled results were different between men (RR: 1.08; 95% CI: 1.05–1.11) and women (RR: 1.05; 95% CI: 0.96–1.14). A linear relationship between alcohol consumption and risk of AF was found in men (p = 0.87) while a J-shaped curve was observed in women (p = 0.00). Regional subgroup analysis yielded broadly comparable results in Americas (RR: 1.07; 95% CI: 1.03–1.12), Europe (RR: 1.04; 95% CI: 0.99–1.1) and Asia (RR: 1.07; 95% CI: 0.99–1.14).ConclusionThe relationship between AF risk and alcohol consumption is linear in men, while a potential non-linear J-shaped relationship is shown in women.Condensed abstractWe conducted a dose-response meta-analysis on the relationship between alcohol consumption and risk of atrial fibrillation. We merged the data of over 10 million participants and found gender differences in the pattern of association with AF and alcohol consumption. The relationship between AF risk and alcohol consumption is linear in men, while a potential non-linear J-shaped relationship is shown in women. In summary, this research is vital in furthering our understanding of the role of alcohol consumption in new-onset AF, especially among different genders.

Alcohol and Atrial Fibrillation

“…A relationship in the form of a "J" curve was found, as high alcohol consumption (>168 g/week) was significantly associated with an increased risk of AF, while moderate consumption (<168 g/week) was characterized by a protective effect [38]. However, the results of this meta-analysis were not confirmed in meta-analysis of 13 prospective studies, covering over 10 million subjects, conducted by Jiang et al [39]. This meta-analysis found that each increase in alcohol consumption by one drink/day is significantly associated with an increased risk of AF (RR = 1.06; 95% CI: 1.03-1.08) [39].…”

“…The most important results relating alcohol consumption and AF are summarized in Table 1 (Ref. [17,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]).…”

“…A meta-analysis by Zhang et al [37] found that moderate and heavy alcohol consumption was significantly associated with the risk of AF among men (HR = 1.21; 95% CI: 1.10-1.33 and HR = 1, respectively, 54; 95% CI: 1.26-1.89), while among women this was only evident with high alcohol consumption (HR = 1.32; 95% CI: 1.10-1.60). In a meta-analysis by Jiang et al [39], the relationship between alcohol consumption and the risk of AF is linear among men, while among women it takes the shape of a "J" curve. In an observational study by Frederiksen et al [47] of 43,758 participants without AF at baseline was found that increasing alcohol consumption in a 5-year follow-up significantly increased the risk of AF only among women.…”

Global association of incidence between atrial fibrillation and the major gastrointestinal cancers: An analysis based on the 2019 Global burden of disease study

“…LC_alcohol exhibited a positive association with AF. Alcohol consumption is a well-established co-risk factor for the development of AF [ 20 , 21 ]. Long-term alcohol intake induces progressive atrial structural remodeling [ 22 ], and acute alcohol consumption exerts direct cellular effects on atrial myocytes and influences autonomic nervous function, creating an electrophysiological environment conducive to AF initiation and maintenance [ 22 ].…”

Nutritional Insights: How Food Choices Affect Atrial Fibrillation

“…Atrial fibrillation, the most common form of clinically relevant arrhythmia, increases the risk of serious health complications such as stroke, heart failure and overall mortality. In the context of alcohol, the scientific literature points to a variety of effects associated with different levels of consumption: from moderate to heavy [12][13][14][15][16].…”