title: Alcohol consumption and the risk of incident atrial fibrillation among people with cardiovascular disease.
abstract: BACKGROUND
  Moderate alcohol consumption may reduce cardiovascular events, but little is known about its effect on atrial fibrillation in people at high risk of such events. We examined the association between moderate alcohol consumption and the risk of incident atrial fibrillation among older adults with existing cardiovascular disease or diabetes.
  
  
  METHODS
  We analyzed data for 30 433 adults who participated in 2 large antihypertensive drug treatment trials and who had no atrial fibrillation at baseline. The patients were 55 years or older and had a history of cardiovascular disease or diabetes with end-organ damage. We classified levels of alcohol consumption according to median cut-off values for low, moderate and high intake based on guidelines used in various countries, and we defined binge drinking as more than 5 drinks a day. The primary outcome measure was incident atrial fibrillation.
  
  
  RESULTS
  A total of 2093 patients had incident atrial fibrillation. The age- and sex-standardized incidence rate per 1000 person-years was 14.5 among those with a low level of alcohol consumption, 17.3 among those with a moderate level and 20.8 among those with a high level. Compared with participants who had a low level of consumption, those with higher levels had an increased risk of incident atrial fibrillation (adjusted hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.04-1.26, for moderate consumption; 1.32, 95% CI 0.97-1.80, for high consumption). Results were similar after we excluded binge drinkers. Among those with moderate alcohol consumption, binge drinkers had an increased risk of atrial fibrillation compared with non-binge drinkers (adjusted HR 1.29, 95% CI 1.02-1.62).
  
  
  CONCLUSIONS
  Moderate to high alcohol intake was associated with an increased incidence of atrial fibrillation among people aged 55 or older with cardiovascular disease or diabetes. Among moderate drinkers, the effect of binge drinking on the risk of atrial fibrillation was similar to that of habitual heavy drinking.
authors.affiliation: Hamilton Health Sciences,McMaster University, Hamilton, Ontario, Canada. fwliangyan@yahoo.com.cn
authors.forename: Yan
authors.initials: Y
authors.lastname: Liang
authors.forename: Andrew
authors.initials: A
authors.lastname: Mente
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
authors.forename: Peggy
authors.initials: P
authors.lastname: Gao
authors.forename: Peter
authors.initials: P
authors.lastname: Sleight
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: Robert
authors.initials: R
authors.lastname: Fagard
authors.forename: Eva
authors.initials: E
authors.lastname: Lonn
authors.forename: Koon K
authors.initials: KK
authors.lastname: Teo
mesh_terms: D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood / Q000453:epidemiology*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D063425:Binge Drinking / Q000097:blood / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario / Q000453:epidemiology; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate