Alcohol Consumption and Risk of Atrial Fibrillation
Key result
Highest alcohol intake linked to ~51% higher AF risk versus lowest intake.
- Estimate 1.51
- 95% CI 1.31-1.74
Why the study?
Results from observational studies evaluating the relationship between alcohol consumption and atrial fibrillation were inconsistent.
Does habitual alcohol intake increase the risk of atrial fibrillation?
Comparison
Highest versus lowest alcohol intake
Design
Meta-analysis
Authors
Discussion
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Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
DCDavid ConenCardiologist and epidemiologist, University Hospital Basel
“A previous meta-analysis of observational studies found evidence for a linear relationship between increasing amounts of alcohol intake and AF, with an estimated 8% increased AF risk associated with each 10 g of alcohol intake. However, several studies included in the meta-analysis assessed alcohol intake retrospectively, after the AF event; and recall bias may have inflated the association between alcohol and AF to some degree.”
“There is now very compelling and consistent evidence that there's a relationship between consuming alcohol and atrial fibrillation and, in fact, now quite convincing evidence that there's a causal relationship.”
TAThomas A. DewlandCardiac electrophysiologist, UC San Francisco
“Several lines of evidence convincingly associate alcohol consumption with AF risk... Overall, these results strongly implicate a causal relationship between alcohol and AF. Nonetheless, even when armed with these data, we still sit face to face with our questioning patients and fumble for an answer. Is one drink per day OK?”
Implication
May support alcohol moderation counseling in AF prevention; hypothesis-generating pending randomized confirmation.
Key Points
- To quantify and summarize the estimated risk of atrial fibrillation associated with habitual alcohol consumption.
- Systematic search of Medline (1966–2009) and Embase (1974–2009) identified observational studies reporting effect measures for atrial fibrillation related to habitual alcohol intake.
- Effect estimates for the highest versus lowest intake were pooled across 14 studies using variance-based methods, and dose-response associations were evaluated with linear and spline regression models.
- The pooled risk estimate for atrial fibrillation comparing the highest to lowest alcohol intake across 14 studies was 1.51 (95% CI: 1.31 to 1.74).
- Linear regression demonstrated a pooled risk estimate of 1.08 per 10 g/day increment in alcohol intake (95% CI: 1.05 to 1.10; R² = 0.43, p < 0.001), with spline regression confirming escalating risk at higher intake levels.
Study Design
Type
Meta-Analysis
Structured PICO
Does habitual alcohol intake increase the risk of atrial fibrillation?
P
Population
Meta-analysis of 14 studies evaluating the association between habitual alcohol consumption and the risk of atrial fibrillation.
E
Exposure
Highest alcohol intake (and increments of 10 g per day)
C
Comparator
Lowest alcohol intake
O
Outcome
Risk of atrial fibrillation (AF)hard clinical
Main Result
Effect estimate: Estimate 1.51 (95% CI 1.31-1.74)
This meta-analysis demonstrates a dose-dependent increase in the risk of atrial fibrillation with alcohol consumption, suggesting abstinence is most favorable for risk reduction.
Cite This Study
Kodama et al. (2011) conducted a meta-analysis in Atrial fibrillation. Alcohol consumption vs. Lowest alcohol intake was evaluated on Atrial fibrillation (Estimate 1.51, 95% CI 1.31-1.74). The highest level of alcohol consumption was associated with an increased risk of atrial fibrillation compared to the lowest intake (pooled estimate 1.51; 95% CI 1.31-1.74).