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More evidence that heavy alcohol consumption is bad for people with atrial fibrillation

Dr Boyoung Joung (Yonsei University College of Medicine, Seoul, Republic of Korea) and colleagues report in the medical journal EP Europace that people with atrial fibrillation (AF) who drink 14 alcoholic drinks a week or more have an increased of complications such as stroke or embolism.

Joung et al, in the study, reviewed data for 9,411 people with AF from 18 tertiary hospitals covering all geographical regions of South Korea. Patients were categorised into four groups according to their weekly alcohol consumption (with one “drink” = 14g of alcohol): abstainer/rare (0g or less than one drink); light (less than 100g or seven drinks); moderate (100–200g or seven to 14 drinks); and heavy (200g or 15 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 AF or for heart failure management. Joung et al 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 authors 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.

Additionally, 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.

Dr 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... The findings indicate that heavy drinking is particularly detrimental for AF 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. While heavy drinking should be strongly discouraged among AF patients, moderate drinking seems to be safe,” he added.

For more information on healthy living with AF, download the AF Association’s AF Fact File from the booklets page.

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