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AF: Moderate alcohol intake possibly associated with a reduced mortality risk

Presented by
Dr Alireza Oraii, Population Health Research Institute, Canada
AHA 2022
Registry data on patients with atrial fibrillation (AF) demonstrated that light or moderate alcohol consumption is not related to higher odds of stroke or major bleeding compared with abstinence. Remarkably, low and moderate drinking seemed to be associated with a lower probability of hospitalisation for heart failure (HF) and all-cause mortality.

“You already know that AF is associated with a higher risk of adverse cardiovascular events, and alcohol drinkers are at an increased risk of recurrent AF episodes; however, the role of alcohol on hard clinical endpoints in the AF population is still uncertain,” Dr Alireza Oraii (Population Health Research Institute, Canada) introduced his research [1].

The cross-sectional study analysed data from the global RE-LY AF Registry containing information from 47 different countries on 1-year outcomes of AF patients who visited emergency rooms. Data on self-reported quantities of alcohol consumption from 14,058 patients were included (mean age 66 years and 48% women). The assessment was performed according to 4 categories, i.e. abstainers, light drinkers (i.e. less than 7 standard drinks per week), moderate drinkers (i.e. 7–13 standard drinks per week), and heavy drinkers (at least 14 standard drinks per week). Endpoints after 1 year included stroke or systemic embolism, major bleeding events, hospitalisation for HF, and all-cause mortality.

Most of just over 12,000 participants did not drink any alcohol and 359 were heavy drinkers. Concerning stroke/systemic embolism, no significant differences were found when comparing each of the alcohol-drinking categories to the non-drinkers. For the 1-year odds of major bleeding, similar results were found for low, moderate, and heavy alcohol consumption versus abstinence.

“Interestingly, our data also suggested that light to moderate drinking habits were associated with significantly lower odds of HF hospitalisation and all-cause mortality,” Dr Oraii added. Light and moderate alcohol intake led to an odds ratio (OR) of 0.75 (95% CI 0.59–0.95) and OR 0.57 (95% CI 0.38–0.85), respectively, compared with no alcohol consumed. Furthermore, the likelihood of all-cause mortality was significantly reduced in those who drank light and moderate versus abstainers: OR 0.42 (95% CI 0.30–0.58) and OR 0.42 (95% CI 0.26–0.68).

“The evidence suggests that alcohol intake in moderation is not associated with excess odds of thromboembolic and major bleeding events in patients with AF and may even reduce odds of mortality and HF hospitalisation. However, a randomised controlled trial will need to be performed to solidify the evidence,” Dr Oraii concluded.

    1. Oraii A, et al. Alcohol consumption and cardiovascular outcomes in patients with atrial fibrillation; a RE-LY AF registry analysis. EA.APS. P270, AHA Scientific Sessions 2022, 05–07 November, Chicago, USA.


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