Abstract 14327: Association Between Alcohol Intake and Incidence of Heart Failure With and Without Reduced Ejection Fraction Among Participants of the VA Million Veteran Program

Abstract

Introduction: Little is known about the relation of total alcohol intake and beverage types on risk of heart failure (HF). This study aims to examine the relation between amount of alcohol consumed and type of alcohol with risk for HF including subtypes [heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction] in a large cohort of US Veterans. Methods: The study cohort included 329,543 Million Veteran Program participants who completed a baseline and lifestyle survey. Subjects with prevalent HF at baseline and incomplete alcohol information were excluded. Moderate alcohol intake was defined as consuming 12-24 g/day for men and 12g/day for women. We used ICD-9-10 codes and EF to define HFpEF and HFrEF. The associations between alcohol intake, beverage preference, and incidence of HFpEF and HFrEF were assessed using Cox proportional hazard model (CPHM) adjusted for age, sex, race, body mass index, cigarette smoking, education, exercise, diet, baseline prevalence of high cholesterol, hypertension, diabetes mellitus, statin use and atrial fibrillation. Results: Mean age was 65 years and 91.4% were men. With mean follow-up of 4.5 years, we observed 20,694 incident HF events (6078 HFrEF and 4531 HFpEF). The CPHM showed J shaped relationship between alcohol consumption and HF risk. Compared to never drinkers, adjusted HRs (95% CI) for HF were 0.89 (0.85, 0.95), 0.85 (0.79,0.91), 0.80 (0.74, 0.86), 0.80 (0.72, 0.88), 0.93 (0.84, 1.04) and 1.03(0.95, 1.12) for categories of current drinkers of ≤6 g/d, >6-12 g/d, >12-24g/d, >24-36g/d, >36-48 g/d and heavy drinking (> 48 g/d)/alcohol use disorder, respectively. We found a similar association pattern between alcohol intake and risk of HFpEF and HFrEF (Fig). There was no difference in alcohol preference and HF risk among light and moderate drinkers. Conclusion: Light to moderate alcohol consumption is associated with a lower risk of heart failure irrespective of subtypes.