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Research Article| Volume 246, P46-52, November 01, 2017

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Alcohol and incident atrial fibrillation – A systematic review and meta-analysis

  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Celine Gallagher
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Jeroen M.L. Hendriks
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Adrian D. Elliott
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Christopher X. Wong
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Geetanjali Rangnekar
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Melissa E. Middeldorp
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Rajiv Mahajan
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Dennis H. Lau
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
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  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Prashanthan Sanders
    Correspondence
    Corresponding author at: Centre for Heart Rhythm Disorders, Department of Cardiology, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
    Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, South Australia, Australia
    Search for articles by this author
  • Author Footnotes
    1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

      Abstract

      Background

      Whilst high levels of alcohol consumption are known to be associated with atrial fibrillation (AF), it is unclear if any level of alcohol consumption can be recommended to prevent the onset of the condition. The aim of this review is to characterise the association between chronic alcohol intake and incident AF.

      Methods and results

      Electronic literature searches were undertaken using PubMed and Embase databases up to 1 February 2016 to identify studies examining the impact of alcohol on the risk of incident AF. Prospective studies reporting on at least three levels of alcohol intake and published in English were eligible for inclusion. Studies of a retrospective or case control design were excluded. The primary study outcome was development of incident AF. Consistent with previous studies, high levels of alcohol intake were associated with an increased incident AF risk (HR 1.34, 95% CI 1.20–1.49, p < 0.001). Moderate levels of alcohol intake were associated with a heightened AF risk in males (HR 1.26, 95% CI 1.04–1.54, p = 0.02) but not females (HR 1.03, 95% CI 0.86–1.25, p = 0.74). Low alcohol intake, of up to 1 standard drink (SD) per day, was not associated with AF development (HR 0.95, 95% CI 0.85–1.06, p = 0.37).

      Conclusions

      Low levels of alcohol intake are not associated with the development of AF. Gender differences exist in the association between moderate alcohol intake and AF with males demonstrating greater increases in risk, whilst high alcohol intake is associated with a heightened AF risk across both genders.

      Keywords

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