Beverage consumption and mortality among adults with atrial fibrillation: a prospective study from UK biobank

Abstract Background Atrial fibrillation (AF) is a common arrhythmia associated with increased mortality and severe complications such as heart failure (HF), stroke, and myocardial infarction. While beverage consumption has been linked to cardiovascular health, its prognostic impact on AF patients remains unclear. Purpose We aim to systematically investigate the association between intake of specific types of beverages and all-cause mortality, cardiovascular mortality, HF and stroke among adults with AF. Methods This study used UK Biobank data, selecting 3,904 AF patients from 502,409 participants, with beverage intake assessed via a 24-hour dietary recall questionnaire. Beverages were classified into artificial sweetened beverages (ASBs), sugar-sweetened beverages (SSBs), natural fruit juices (NJs), milk, coffee, tea, and water. All-cause mortality and cardiovascular-related death was set as the primary outcome, while newly diagnosed HF, and stroke were secondary outcomes. The Cox proportional hazards regression model was used to assess the associations between beverage intake and the risk of outcomes. Results During the median follow-up period of 11.62 years, 575 all-cause deaths, 211 cardiovascular-related deaths, 781 new HF cases, and 344 stroke events occurred. Higher ASBs intake (1 cups/day) was associated with an increased risk of all-cause mortality (HR: 1.14, 95% CI: 1.02–1.28, P trend = 0.012), cardiovascular disease mortality (HR: 1.81, 95% CI: 1.21–2.71, P trend = 0.004), and stroke (HR: 2.32, 95% CI: 1.41–3.80, P trend 0.001). In contrast, higher NJs consumption (1 cups/day) was associated with a lower risk of all-cause mortality (P 0.05). Tea (4 cups/day) and coffee (1–2 cups/day) were linked to reduced all-cause mortality risk, but no significant associations were observed for cardiovascular mortality, HF, or stroke. Substitution analyses suggested that replacing ASBs with NJs, tea, or coffee significantly reduced all-cause mortality risk. Conclusions In AF patients, high ASBs consumption is linked to increased risks of all-cause mortality, cardiovascular mortality, and stroke, whereas NJs, tea, and coffee intake may have protective effects. These findings highlight the potential impact of beverage choices on long-term health outcomes in this population.