Alcohol consumption and risk of cardiovascular outcomes and bleeding in patients with established atrial fibrillation.
Journal
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
ISSN: 1488-2329
Titre abrégé: CMAJ
Pays: Canada
ID NLM: 9711805
Informations de publication
Date de publication:
25 Jan 2021
25 Jan 2021
Historique:
accepted:
01
09
2020
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
27
7
2021
Statut:
ppublish
Résumé
Little is known about the association between alcohol consumption and risk of cardiovascular events in patients with established atrial fibrillation (AF). The main aim of the current study was to investigate the associations of regular alcohol intake with incident stroke or systemic embolism in patients with established AF. To assess the association between alcohol consumption and cardiovascular events in patients with established AF, we combined data from 2 comparable prospective cohort studies that followed 3852 patients with AF for a median of 3.0 years. Patients were grouped into 4 categories of daily alcohol intake (none, > 0 to < 1, 1 to < 2 and ≥ 2 drinks/d). The primary outcome was a composite of stroke and systemic embolism. Secondary outcomes were all-cause mortality, myocardial infarction, hospital admission for acute heart failure, and a composite of major and clinically relevant nonmajor bleeding. Associations were assessed using time-updated, multivariable-adjusted Cox proportional hazards models. Mean age (± standard deviation) was 71 ± 10 years (28% were women and 84% were on oral anticoagulants). We observed 136 confirmed strokes or systemic emboli. Compared with nondrinkers, adjusted hazard ratios for the primary outcome event were 0.87, 95% confidence interval (CI) 0.55-1.37 for > 0 to < 1 drinks/d; 0.70, 95% CI 0.39-1.25 for 1 to < 2 drinks/d; and 0.96, 95% CI 0.56-1.67 for ≥ 2 drinks/d ( In patients with AF, we did not find a significant association between low to moderate alcohol intake and risk of stroke or other cardiovascular events. Our findings do not support special recommendations for patients with established AF with regard to alcohol consumption. ClinicalTrials.gov, no. NCT02105844.
Sections du résumé
BACKGROUND
BACKGROUND
Little is known about the association between alcohol consumption and risk of cardiovascular events in patients with established atrial fibrillation (AF). The main aim of the current study was to investigate the associations of regular alcohol intake with incident stroke or systemic embolism in patients with established AF.
METHODS
METHODS
To assess the association between alcohol consumption and cardiovascular events in patients with established AF, we combined data from 2 comparable prospective cohort studies that followed 3852 patients with AF for a median of 3.0 years. Patients were grouped into 4 categories of daily alcohol intake (none, > 0 to < 1, 1 to < 2 and ≥ 2 drinks/d). The primary outcome was a composite of stroke and systemic embolism. Secondary outcomes were all-cause mortality, myocardial infarction, hospital admission for acute heart failure, and a composite of major and clinically relevant nonmajor bleeding. Associations were assessed using time-updated, multivariable-adjusted Cox proportional hazards models.
RESULTS
RESULTS
Mean age (± standard deviation) was 71 ± 10 years (28% were women and 84% were on oral anticoagulants). We observed 136 confirmed strokes or systemic emboli. Compared with nondrinkers, adjusted hazard ratios for the primary outcome event were 0.87, 95% confidence interval (CI) 0.55-1.37 for > 0 to < 1 drinks/d; 0.70, 95% CI 0.39-1.25 for 1 to < 2 drinks/d; and 0.96, 95% CI 0.56-1.67 for ≥ 2 drinks/d (
INTERPRETATION
CONCLUSIONS
In patients with AF, we did not find a significant association between low to moderate alcohol intake and risk of stroke or other cardiovascular events. Our findings do not support special recommendations for patients with established AF with regard to alcohol consumption.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, no. NCT02105844.
Identifiants
pubmed: 33667180
pii: 193/4/E117
doi: 10.1503/cmaj.200778
pmc: PMC7954562
doi:
Substances chimiques
Anticoagulants
0
Warfarin
5Q7ZVV76EI
Banques de données
ClinicalTrials.gov
['NCT02105844']
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
E117-E123Informations de copyright
© 2021 Joule Inc. or its licensors.
Déclaration de conflit d'intérêts
Competing interests: Jürg Beer reports receiving grants from the Swiss National Foundation of Science and the Swiss Heart Foundation. Richard Kobza reports receiving institutional grants from Abbott, Biosense-Webster, Boston-Scientific, Biotronik, Medtronic and Sis-Medical. Giorgio Moschovitis reports receiving advisory board fees from Boehringer Ingelheim, AstraZeneca and Novartis, outside of the submitted work. Michael Kühne reports receiving personal fees from Bayer, Böhringer Ingelheim, Pfizer BMS, Daiichi Sankyo, Medtronic, Biotronik, Boston Scientific and Johnson &Johnson, and grants from Bayer, Pfizer BMS, Boston Scientific, the Swiss National Science Foundation and the Swiss Heart Foundation. Leo Bonati reports receiving grants from the Swiss National Science Foundation, the Swiss Heart Foundation and the University of Basel; grants and nonfinancial support from Bayer and AstraZeneca; personal fees from Amgen, Bristol-Myers Squibb and Claret Medical, outside the submitted work. Stefan Osswald reports receiving research grants from the Swiss National Science Foundation, the Swiss Heart Foundation and the Cardiovascular Research Foundation, Basel. David Conen reports receiving speaker fees from Servier, Canada, outside of the current work. No other competing interests were declared.
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