Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

Dora Csengeri; Ngoc-Anh Sprünker; Augusto Di Castelnuovo; Teemu Niiranen; Julie Kk Vishram-Nielsen; Simona Costanzo; Stefan Söderberg; Steen M Jensen; Erkki Vartiainen; Maria Benedetta Donati; Christina Magnussen; Stephan Camen; Francesco Gianfagna; Maja-Lisa Løchen; Frank Kee; Jukka Kontto; Ellisiv B Mathiesen; Wolfgang Koenig; Blankenberg Stefan; Giovanni de Gaetano; Torben Jørgensen; Kari Kuulasmaa; Tanja Zeller; Veikko Salomaa; Licia Iacoviello; Renate B Schnabel

doi:10.1093/eurheartj/ehaa953

Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

Dora Csengeri, Ngoc-Anh Sprünker, Augusto Di Castelnuovo, Teemu Niiranen, Julie Kk Vishram-Nielsen, Simona Costanzo, Stefan Söderberg, Steen M Jensen, Erkki Vartiainen, Maria Benedetta Donati, Christina Magnussen, Stephan Camen, Francesco Gianfagna, Maja-Lisa Løchen, Frank Kee, Jukka Kontto, Ellisiv B Mathiesen, Wolfgang Koenig, Blankenberg Stefan, Giovanni de GaetanoTorben Jørgensen, Kari Kuulasmaa, Tanja Zeller, Veikko Salomaa, Licia Iacoviello, Renate B Schnabel

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Abstract

AIMS : There is inconsistent evidence on the relation of alcohol intake with incident atrial fibrillation (AF), in particular at lower doses. We assessed the association between alcohol consumption, biomarkers, and incident AF across the spectrum of alcohol intake in European cohorts.

METHODS AND RESULTS : In a community-based pooled cohort, we followed 107 845 individuals for the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. We collected information on classical cardiovascular risk factors and incident heart failure (HF) and measured the biomarkers N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I. The median age of individuals was 47.8 years, 48.3% were men. The median alcohol consumption was 3 g/day. N = 5854 individuals developed AF (median follow-up time: 13.9 years). In a sex- and cohort-stratified Cox regression analysis alcohol consumption was non-linearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16, 95% CI 1.11-1.22, P < 0.001. Associations were similar across types of alcohol. In contrast, alcohol consumption at lower doses was associated with reduced risk of incident HF. The association between alcohol consumption and incident AF was neither fully explained by cardiac biomarker concentrations nor by the occurrence of HF.

CONCLUSIONS : In contrast to other cardiovascular diseases such as HF, even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF, which needs to be considered in AF prevention.

Original language	English
Number of pages	8
Journal	European Heart Journal
Early online date	13 Jan 2021
DOIs	https://doi.org/10.1093/eurheartj/ehaa953
Publication status	Early online date - 13 Jan 2021

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Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes
© 2021 The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]
Final published version, 866 KBLicence: CC BY-NC

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Csengeri, D., Sprünker, N.-A., Di Castelnuovo, A., Niiranen, T., Vishram-Nielsen, J. K., Costanzo, S., Söderberg, S., Jensen, S. M., Vartiainen, E., Donati, M. B., Magnussen, C., Camen, S., Gianfagna, F., Løchen, M.-L., Kee, F., Kontto, J., Mathiesen, E. B., Koenig, W., Stefan, B., ... Schnabel, R. B. (2021). Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes. European Heart Journal. Advance online publication. https://doi.org/10.1093/eurheartj/ehaa953

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title = "Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes",

abstract = "AIMS : There is inconsistent evidence on the relation of alcohol intake with incident atrial fibrillation (AF), in particular at lower doses. We assessed the association between alcohol consumption, biomarkers, and incident AF across the spectrum of alcohol intake in European cohorts.METHODS AND RESULTS : In a community-based pooled cohort, we followed 107 845 individuals for the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. We collected information on classical cardiovascular risk factors and incident heart failure (HF) and measured the biomarkers N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I. The median age of individuals was 47.8 years, 48.3% were men. The median alcohol consumption was 3 g/day. N = 5854 individuals developed AF (median follow-up time: 13.9 years). In a sex- and cohort-stratified Cox regression analysis alcohol consumption was non-linearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16, 95% CI 1.11-1.22, P < 0.001. Associations were similar across types of alcohol. In contrast, alcohol consumption at lower doses was associated with reduced risk of incident HF. The association between alcohol consumption and incident AF was neither fully explained by cardiac biomarker concentrations nor by the occurrence of HF.CONCLUSIONS : In contrast to other cardiovascular diseases such as HF, even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF, which needs to be considered in AF prevention.",

author = "Dora Csengeri and Ngoc-Anh Spr{\"u}nker and {Di Castelnuovo}, Augusto and Teemu Niiranen and Vishram-Nielsen, {Julie Kk} and Simona Costanzo and Stefan S{\"o}derberg and Jensen, {Steen M} and Erkki Vartiainen and Donati, {Maria Benedetta} and Christina Magnussen and Stephan Camen and Francesco Gianfagna and Maja-Lisa L{\o}chen and Frank Kee and Jukka Kontto and Mathiesen, {Ellisiv B} and Wolfgang Koenig and Blankenberg Stefan and {de Gaetano}, Giovanni and Torben J{\o}rgensen and Kari Kuulasmaa and Tanja Zeller and Veikko Salomaa and Licia Iacoviello and Schnabel, {Renate B}",

note = "{\textcopyright} The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2021",

month = jan,

day = "13",

doi = "10.1093/eurheartj/ehaa953",

language = "English",

journal = "European Heart Journal",

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Csengeri, D, Sprünker, N-A, Di Castelnuovo, A, Niiranen, T, Vishram-Nielsen, JK, Costanzo, S, Söderberg, S, Jensen, SM, Vartiainen, E, Donati, MB, Magnussen, C, Camen, S, Gianfagna, F, Løchen, M-L, Kee, F, Kontto, J, Mathiesen, EB, Koenig, W, Stefan, B, de Gaetano, G, Jørgensen, T, Kuulasmaa, K, Zeller, T, Salomaa, V, Iacoviello, L & Schnabel, RB 2021, 'Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes', European Heart Journal. https://doi.org/10.1093/eurheartj/ehaa953

TY - JOUR

T1 - Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

AU - Csengeri, Dora

AU - Sprünker, Ngoc-Anh

AU - Di Castelnuovo, Augusto

AU - Niiranen, Teemu

AU - Vishram-Nielsen, Julie Kk

AU - Costanzo, Simona

AU - Söderberg, Stefan

AU - Jensen, Steen M

AU - Vartiainen, Erkki

AU - Donati, Maria Benedetta

AU - Magnussen, Christina

AU - Camen, Stephan

AU - Gianfagna, Francesco

AU - Løchen, Maja-Lisa

AU - Kee, Frank

AU - Kontto, Jukka

AU - Mathiesen, Ellisiv B

AU - Koenig, Wolfgang

AU - Stefan, Blankenberg

AU - de Gaetano, Giovanni

AU - Jørgensen, Torben

AU - Kuulasmaa, Kari

AU - Zeller, Tanja

AU - Salomaa, Veikko

AU - Iacoviello, Licia

AU - Schnabel, Renate B

PY - 2021/1/13

Y1 - 2021/1/13

N2 - AIMS : There is inconsistent evidence on the relation of alcohol intake with incident atrial fibrillation (AF), in particular at lower doses. We assessed the association between alcohol consumption, biomarkers, and incident AF across the spectrum of alcohol intake in European cohorts.METHODS AND RESULTS : In a community-based pooled cohort, we followed 107 845 individuals for the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. We collected information on classical cardiovascular risk factors and incident heart failure (HF) and measured the biomarkers N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I. The median age of individuals was 47.8 years, 48.3% were men. The median alcohol consumption was 3 g/day. N = 5854 individuals developed AF (median follow-up time: 13.9 years). In a sex- and cohort-stratified Cox regression analysis alcohol consumption was non-linearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16, 95% CI 1.11-1.22, P < 0.001. Associations were similar across types of alcohol. In contrast, alcohol consumption at lower doses was associated with reduced risk of incident HF. The association between alcohol consumption and incident AF was neither fully explained by cardiac biomarker concentrations nor by the occurrence of HF.CONCLUSIONS : In contrast to other cardiovascular diseases such as HF, even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF, which needs to be considered in AF prevention.

AB - AIMS : There is inconsistent evidence on the relation of alcohol intake with incident atrial fibrillation (AF), in particular at lower doses. We assessed the association between alcohol consumption, biomarkers, and incident AF across the spectrum of alcohol intake in European cohorts.METHODS AND RESULTS : In a community-based pooled cohort, we followed 107 845 individuals for the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. We collected information on classical cardiovascular risk factors and incident heart failure (HF) and measured the biomarkers N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I. The median age of individuals was 47.8 years, 48.3% were men. The median alcohol consumption was 3 g/day. N = 5854 individuals developed AF (median follow-up time: 13.9 years). In a sex- and cohort-stratified Cox regression analysis alcohol consumption was non-linearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16, 95% CI 1.11-1.22, P < 0.001. Associations were similar across types of alcohol. In contrast, alcohol consumption at lower doses was associated with reduced risk of incident HF. The association between alcohol consumption and incident AF was neither fully explained by cardiac biomarker concentrations nor by the occurrence of HF.CONCLUSIONS : In contrast to other cardiovascular diseases such as HF, even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF, which needs to be considered in AF prevention.

U2 - 10.1093/eurheartj/ehaa953

DO - 10.1093/eurheartj/ehaa953

M3 - Article

C2 - 33438022

SN - 0195-668X

JO - European Heart Journal

JF - European Heart Journal

ER -

Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

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