Alcohol May Kindle Atrial Fibrillation, a Major Killer that Often Leads to Stroke
Mardi Gras, Saturday nights, Super Bowl Sunday, and other days when more people consume more alcohol are also associated with more emergency room visits for atrial fibrillation, reported a new study led by UC San Francisco.
The study, published Jan. 12, in Nature Cardiovascular Research, shows an association between increased drinking and hospital visits for atrial fibrillation (AF) in a large population, and links acute alcohol consumption with an increased incidence of new-onset AF in previously undiagnosed individuals.
“Our new data suggest that acute alcohol consumption in the general population is associated with a higher risk of an episode of atrial fibrillation, including a higher risk for a first episode of atrial fibrillation among individuals never previously diagnosed with the condition,” said senior study author Gregory Marcus, MD, MAS, a professor of Medicine at UCSF and associate chief of cardiology for research at UCSF Health. “Worldwide, alcohol is the most popularly consumed drug, and it now is clear that alcohol consumption is an important risk factor for atrial fibrillation.”
Atrial fibrillation most often arises in individuals with pre-existing heart conditions, but other chronic health conditions, including potentially modifiable behaviors such as obesity and alcohol consumption, also have previously been associated with its development. However, acute triggers of potentially life-threatening AF episodes can be more difficult to study, Marcus said.
In the study, the researchers first identified days when people are more likely to drink more. The scientists analyzed data from 36,158 people from all 50 US states and 59 other countries who used a commercially available, Bluetooth-enabled breathalyzer device – a total of 1,269,054 breath alcohol measurements – and looked for days of the year when individuals used their devices significantly more often or had higher breathalyzer measurements.
The researchers determined that the breathalyzer users consumed more alcohol than usual on eight different holidays or days of recurrent national events: New Year’s Day, Martin Luther King Jr. Day, Super Bowl Sunday, initiation of daylight-saving time, July 4, Christmas, FIFA World Cup and Father’s Day.
“In the broad general population we wanted to test the hypothesis that during the dates and events we first identified as being associated with elevated alcohol consumption in the breathalyzer users, we would also see more ER visits for atrial fibrillation,” Marcus said. “This would imply that there is a nearly immediate relationship between excess alcohol consumption and more atrial fibrillation within the population.”
The researchers reviewed records from hospital emergency room visits between Jan. 1, 2005, to Dec. 30, 2015, and identified visits coded for a diagnosis AF. They compared the weeks associated with greater alcohol consumption to all other weeks of the year to see if there were more AF visits on days when people are known to drink more. They found that there was an elevated number of hospital visits for AF when those events were compared to all other days of the year.
In addition, compared to other days, on the days associated with elevated drinking, the researchers identified an even greater percentage increase in hospital visits for AF among those not previously diagnosed with AF, in comparison to the increase in ER visits on these same days among the previously diagnosed with the condition. According to Marcus, the study suggests that many new cases of AF are triggered specifically by acute alcohol consumption.
“This may be kind of a wake-up call for those individuals who have an identifiable trigger for their atrial fibrillation, who we might presume would be more highly motivated to avoid alcohol consumption and subsequently to experience a lowering of their atrial fibrillation risk,” he said.