Table 10.

Risk of AF and alcohol consumption

Study	Design	Subjects	FU	Alcohol, drinks/day (week)	AF, n	Risk (95% Cl)
(a) Population cohorts
Mukamal et al.175   Copenhagen City   Heart study	Prospective cohort	16415 men and women free of AF at baseline	26 yrs	Men Multivariable risk <1 drinks/week >35 drinks/week: Adjusted for CHD, CHF,BP Women Multivariable risk <1 drinks/week 21–27 drinks/week	1071	Reference (risk in HR) 1.45 (1.02–2.04) HR 1.63 (1.15–2.31) In men 5% of incident AF is attributable for heavy drinking Reference (risk in HR) 1.04 (0.64–1.70) P = 0.87 for trend
Conen et al.176   Women Health Study	Prospective cohort	34715 women <45 yrs free of AF	12.4 yrs median	0 drinks/day ≥2 drinks/day	653	Reference (risk in HR) 1.6 (1.13–2.25)
Djousse et al.177   Framingham   Heart Study	Prospective cohort Case–control analysis	1055 who developed AF 4672 controls men and women	>50 yrs	0 g/day >36 g/day	1055	Reference (risk in OR) 1.34 (1.01–1.78)
Larsson et al.178   Swedish Cohort Study	Prospective cohort	79019 men and women free of AF at baseline	12 yrs	Dose responsea <1 drink/week 15–21 drinks/week >21 drinks/week Binge drinking (>5 drinks/single occasion) Type of drinks Liquor 7–14 drinks/week >14 drinks/week Wine >14 drinks/week Beer	7245	Reference (risk—RR) 1.14(1.01–1.28) 1.39 (1.22–1.58) 1.13 (1.05–1.32) 1.13 (1.01–1.28) 1.43 (1.14–1.74) 1.30 (1.06–1.61) NS
Kodama et al.179	Meta-analysis 14 observational cohort and case-control studies	14 studies 130 820 participants 7558 cases 9 studies 126 051 participants 6341 cases	2.5–44 yrs	Overall Highest vs. lowest alcohol intake Dose–response (4–86.4 g/day)	7558 6341	Pooled OR/RR 1.51 (1.31-1-74) RR 1.8 (1.05–1.10) per 10 g alcohol per day
Larsson et al.178	Meta-analysis 7 prospective cohort studies	206073 participants 12 554 cases men, women	4.7 to >50 yrs	0 drinks/daya 1 drink/day 2 drinks/day 3 drinks/day 4 drinks/day 5 drinks/day Overall	12554	Reference (risk in RR) 1.08 (1.06–1.10) 1.17 (1.13–1.21) 1.26 (1.19–1.33) 1.36 (1.27–1.46) 1.47 (1.34–1.61) 1.08 (1.06–110) 8% (6–10%) increase in AF risk per 1 drink/day increment
(b) Intervention studies
Pathak et al.148   ARREST-AF	Prospective cohort study	281 pts with AF undergoing catheter ablation 68 pts RFM 88 pts controls	2 yrs	RFM—alcohol <30 g/week + BP, lipids and glycemic control, weight reduction, smoking cessation vs. control	–	RFM predictor of arrhythmia free survival HR 4.8 (2.04–11.4)

AF, atrial fibrillation; BP, blood pressure; CHD, coronary heart disease; CHF, chronic heart failure; Cl, confidence interval; FU, follow-up; HR, hazard ratio; OR, odds ratio; RR, relative risk; RFM, risk factor modification; pts, patients; yrs, years.

^aStandard drinks = 12 g alcohol. One standard drink corresponds to ~40 mL liquor, 80 mL strong wine, 150 mL wine, 330 mL class III beer (alcohol by volume, >3.5%), 50 mL Class II beer (2.8–3.5%), or 660 mL class I beer (<2.25%).