Abstract
Background: Excessive alcohol intake is the risk of death, cerebrovascular event and bleeding. On the other hand, moderate drinking reduces the risk of cardiovascular event. However, the effect of alcohol consumption habit on mortality and cardiovascular event in AF patients remains unclear. Method: The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, which is a typical urban district of Japan. We started to enroll patients from March 2011, and follow-up data were available for 4,466 patients by the end of November 2019. In the entire cohort, data of alcohol drinking were available for 2,944 patients. 834 patients drank daily, 554 socially and 1556 hardly (daily, socially and hardly group, respectively). Result: Compared with hardly groups, patients in daily and socially groups were younger, more often male, more in body weight and more likely to have persistent/permanent type AF. Daily and socially groups were less likely to have heart failure, chronic kidney disease and had lower CHA 2 DS 2 -VASc score. Hypertension and prior stroke/SE were the highest in daily group. Pulse rate, diabetes mellitus and prior bleeding were comparable between three groups. During the median follow-up of 1,482 days, the incidence rate of stroke/SE was significantly higher in hardly group than daily or socially groups (daily vs. socially vs. hardly: 1.19 vs. 1.11 vs. 1.49 per 100 person-years, respectively, log rank p=0.006). The incidence rates of all-cause death (2.45 vs. 3.15 vs. 4.44, p<0.0001) and cardiac death (0.26 vs. 0.46 vs. 0.67, p=0.0004) were also significantly higher in hardly group than the other two groups. The incidence rate of major bleeding was not significantly different between three groups (1.35 vs. 1.20 vs. 1.30, p=0.39). On multivariate Cox regression analysis, daily drinking was significantly associated with lower risk of all-cause death and cardiac death. There was no other association between the groups. Conclusion: As compared with patients drinking alcohol, the risk of stroke/SE, all-cause death, cardiac death in hardly drinking patients were significantly higher. Daily drinking was significantly associated with lower risk of all-cause death and cardiac death.
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