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Critique 185: An innovative assessment of alcohol consumption and the risk of atrial fibrillation – 28 April 2016

A study from Denmark assessed alcohol intake as a risk factor for adverse events among patients with incident atrial fibrillation (AF). The population based cohort study was based on 57 053 participants (27 178 men and 29 875 women) aged between 50 and 64 years from the Danish Diet, Cancer and Health study included. The study population included the 3107 participants (1999 men, 1108 women) who developed incident AF after incusion in the study.

During a median follow-up of 4.9 years, 608 deaths and 211 thromboembolic events occurred. Of those who developed AF, 690 (35%) men and 233 (21%) women had a high intake of alcohol (>20 drinks/week for men and >13 drinks/week for women). After adjustment for use of oral anticoagulation and components of the CHA2DS2-VASc score (score for atrial fibrillation stroke risk), men with an intake of >27 drinks/week had a higher risk for thromboembolism or death (hazard ratio (HR) 1.33, 95% CI 1.08 to 1.63) than men with an intake of <14 drinks/week. Women with an intake of >20 drinks/week also had a higher risk (HR 1.23, 95% CI 0.78 to 1.96) than women in the low intake category. The higher risk among men was primarily driven by mortality (HR 1.51, 95% CI 1.20 to 1.89), whereas the risk found among women was driven by thromboembolism (HR 1.71, 95% CI 0.81 to 3.60).

The authors conclude that high alcohol intake predicts thromboembolism or death, even after adjustment for established clinical risk factors, and may help identify high risk AF patients who could be targeted for stroke and cardiovascular prevention strategies.

Source: Alcohol intake and prognosis of atrial fibrillation patients Thure Filskov Overvad, Lars Hvilsted Rasmussen, Flemming Skjøth, Kim Overvad, Ida Ehlers Albertsen, Deirdre A Lane.Heart. 2013 Aug;99(15):1093-9. Epub 2013 Jun 13.

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