Alcohol and Afib: Danger of evidence with very few sips per day

Despite the proven cardiovascular benefits of light drinking, very little alcohol was still linked to incidental atrial fibrillation (Afib) in a large observational study.

An increased risk of Afib was observed with only one daily drink containing 12 g of ethanol (HR 1.16, 95% CI 1.11–1.22), whether the drink contained 120 mL of wine (four-fifths of one normal glass), 330 mL of beer (approximately) can value), or 40 mL of spirits (about one photo), reports Renate Schnabel, MD, of the Heart & Vessel Center of the University of Hamburg, Germany, and colleagues.

Even a small amount of alcohol, at 2 g per day, was slightly associated with Afib risk over nearly 14 years of follow-up (HR 1.02, 95% CI 1.0–1.04), they wrote in the Journal of the Heart of Europe.

The decisions were consistent for both men and women. The relationship between alcohol and modern Afib remained unchanged after a history of heart failure and the cardiac biomarkers NT-proBNP and hs-troponin I.

“Our large community-based study clearly shows that low alcohol consumption is already associated with an increased risk for an Afib event. We saw an increasingly nonlinear relationship between alcohol consumption. and the Afib event, independent of common opposition, ”the Schnabel group concluded.

There has been a lack of information on low alcohol levels in the literature linking alcohol and Afib.

“Combined with a recent randomized trial showing that a reduction in alcohol consumption has reduced Afib’s recycling, these data suggest that reducing alcohol consumption may be important for both prevention and control of Afib, said Jorge Wong, MD, MPH, and David Conen, MD, MPH, both of the McMaster University Population Research Institute in Hamilton, Ontario.

“The net clinical benefit of drinking very little alcohol needs further investigation, and would be preferable in randomized trials with appropriate potency. Until then, everyone needs to [his or her] their own favorite educational decision is whether it is beneficial and safe to consume up to 1 alcohol per day, ”they wrote in an accompanying editorial.

For their study, Schnabel and colleagues gathered five European community groups with 107,845 adults – then down to 100,092 (median age 47.8; 48.3% men) after banning people with a history of Afib or atrial flutter.

Self-reported alcohol consumption averaged 3 g (a quarter of drink) per day.

Based on questionnaires and hospital records, 5,854 people developed Afib over the median age of 13.9 years.

A J-shaped relationship between drinking and incidental heart failure was also found: consumption of less than 20 g of alcohol (1.6 drinks) per day was associated with lower risk, whereas consumption was associated with greater risk. more, find study authors.

The reliability of the study on self-reported drinking patterns was a major limitation, the Schnabel group acknowledged. The researchers also warned that they only had biomarker levels at baseline, and that some cases of Afib may not have been identified due to a lack of systematic screening among study participants.

Moreover, “the study did not describe the overall risks of Afib associated with low levels of alcohol. This important issue needs to be taken into account when also considering the links which may be beneficial in terms of incorporating alcohol with other cardiovascular products, ”according to Wong and Conen.

“The effects of alcohol on atrial electrophysiology tend to depend on a number of factors including changes in atrial reproduction, vagal tone, and direct myocardial injury and fibrosis. More studies are needed examining how alcohol affects atrial electrophysiology through its possible pathways, ”the editors said.