Alcohol Intake and Cardiovascular Outcomes in Patients With Atrial Fibrillation: RE-LY AF Registry Analysis

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-06-05 DOI:10.1111/anec.70096

Alireza Oraii, David Conen, Linda S. Johnson, William F. McIntyre, Faith Kirabo, Kumar Balasubramanian, Alexander P. Benz, Jonas Oldgren, Jens Cosedis Nielsen, Jeff Healey

{"title":"Alcohol Intake and Cardiovascular Outcomes in Patients With Atrial Fibrillation: RE-LY AF Registry Analysis","authors":"Alireza Oraii, David Conen, Linda S. Johnson, William F. McIntyre, Faith Kirabo, Kumar Balasubramanian, Alexander P. Benz, Jonas Oldgren, Jens Cosedis Nielsen, Jeff Healey","doi":"10.1111/anec.70096","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Alcohol intake increases recurrence of atrial fibrillation (AF), but its relationship with cardiovascular outcomes is less well characterized. We aimed to study the association between different levels of alcohol intake and cardiovascular outcomes in a global cohort of patients with AF.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This is a cross-sectional analysis of the RE-LY AF registry, including 15,400 patients with AF who visited emergency departments in 47 countries. Patients were categorized into abstainers, light (< 7 standard drinks [SD]/week), moderate (7–13 SD/week), and heavy drinkers (≥ 14 SD/week). Outcomes were stroke/systemic embolism, heart failure (HF) hospitalization, and major bleeding at 1-year follow-up. Logistic mixed-effects regression models were used to calculate multivariable-adjusted odds ratios (aOR) with a 95% confidence interval (CI).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total,14,058 patients (mean age = 65.9 ± 14.7 years, 48.0% women) with available alcohol intake level data were included. This consisted of 12,091 (86.0%) abstainers, 1150 (8.2%) light, 458 (3.3%) moderate, and 359 (2.6%) heavy drinkers. The odds of stroke/systemic embolism were not significantly different in light (aOR = 0.88, 95% CI: 0.60–1.28), moderate (aOR = 0.91, 95% CI: 0.53–1.57) or heavy drinkers (aOR = 0.79, 95% CI: 0.41–1.54) compared to abstainers. Major bleedings were numerically, but not statistically significantly, higher among heavy drinkers (aOR = 1.52, 95% CI: 0.82–2.80). Compared to abstainers, alcohol intake was associated with fewer HF hospitalizations (light: aOR = 0.73, 95% CI: 0.58–0.92; moderate: aOR = 0.53, 95% CI: 0.35–0.78; heavy: aOR = 0.63, 95% CI: 0.41–0.98). However, this protective association was observed only in upper-middle and high-income countries (<i>p</i>-interaction < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Alcohol drinking is unlikely to be associated with increased thromboembolic events in patients with AF, but may be associated with a lower risk of HF hospitalizations.</p>\n </section>\n </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 4","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70096","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Noninvasive Electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/anec.70096","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Alcohol intake increases recurrence of atrial fibrillation (AF), but its relationship with cardiovascular outcomes is less well characterized. We aimed to study the association between different levels of alcohol intake and cardiovascular outcomes in a global cohort of patients with AF.

Methods

This is a cross-sectional analysis of the RE-LY AF registry, including 15,400 patients with AF who visited emergency departments in 47 countries. Patients were categorized into abstainers, light (< 7 standard drinks [SD]/week), moderate (7–13 SD/week), and heavy drinkers (≥ 14 SD/week). Outcomes were stroke/systemic embolism, heart failure (HF) hospitalization, and major bleeding at 1-year follow-up. Logistic mixed-effects regression models were used to calculate multivariable-adjusted odds ratios (aOR) with a 95% confidence interval (CI).

Results

In total,14,058 patients (mean age = 65.9 ± 14.7 years, 48.0% women) with available alcohol intake level data were included. This consisted of 12,091 (86.0%) abstainers, 1150 (8.2%) light, 458 (3.3%) moderate, and 359 (2.6%) heavy drinkers. The odds of stroke/systemic embolism were not significantly different in light (aOR = 0.88, 95% CI: 0.60–1.28), moderate (aOR = 0.91, 95% CI: 0.53–1.57) or heavy drinkers (aOR = 0.79, 95% CI: 0.41–1.54) compared to abstainers. Major bleedings were numerically, but not statistically significantly, higher among heavy drinkers (aOR = 1.52, 95% CI: 0.82–2.80). Compared to abstainers, alcohol intake was associated with fewer HF hospitalizations (light: aOR = 0.73, 95% CI: 0.58–0.92; moderate: aOR = 0.53, 95% CI: 0.35–0.78; heavy: aOR = 0.63, 95% CI: 0.41–0.98). However, this protective association was observed only in upper-middle and high-income countries (p-interaction < 0.001).

Conclusion

Alcohol drinking is unlikely to be associated with increased thromboembolic events in patients with AF, but may be associated with a lower risk of HF hospitalizations.

查看原文本刊更多论文

房颤患者的酒精摄入和心血管预后：RE-LY AF登记分析

背景：饮酒增加心房颤动（AF）的复发，但其与心血管预后的关系尚不清楚。我们的目的是研究全球房颤患者队列中不同水平的酒精摄入与心血管结局之间的关系。方法这是RE-LY房颤登记的横断面分析，包括47个国家的15400名房颤患者就诊急诊。患者分为不饮酒者、轻度饮酒者（7标准饮酒量[SD]/周）、中度饮酒者（7 - 13标准饮酒量[SD]/周）和重度饮酒者（≥14标准饮酒量/周）。1年随访结果为卒中/全身性栓塞、心力衰竭住院和大出血。采用Logistic混合效应回归模型计算多变量校正优势比（aOR），置信区间为95%。结果共有14058例患者（平均年龄= 65.9±14.7岁，其中48.0%为女性）具有可获得的酒精摄入水平数据。其中包括12091名（86.0%）戒酒者，1150名（8.2%）轻度饮酒者，458名（3.3%）中度饮酒者和359名（2.6%）重度饮酒者。与不饮酒者相比，轻度饮酒者（aOR = 0.88, 95% CI: 0.60-1.28）、中度饮酒者（aOR = 0.91, 95% CI: 0.53-1.57）或重度饮酒者（aOR = 0.79, 95% CI: 0.41-1.54）发生中风/全身栓塞的几率无显著差异。重度出血在数值上高于重度饮酒者，但无统计学意义（aOR = 1.52, 95% CI: 0.82-2.80）。与不饮酒者相比，酒精摄入与HF住院率降低相关(轻度：aOR = 0.73, 95% CI: 0.58-0.92；中度：aOR = 0.53, 95% CI: 0.35-0.78；重度：aOR = 0.63, 95% CI: 0.41-0.98)。然而，这种保护性关联仅在中高收入和高收入国家中观察到（p-相互作用<； 0.001）。结论：饮酒不太可能与房颤患者血栓栓塞事件增加相关，但可能与心衰住院风险降低相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.