Moderate Alcohol Consumption Is Associated With Lower Risk for Heart Failure But Not Atrial Fibrillation

Augusto Di Castelnuovo, Simona Costanzo, Marialaura Bonaccio, Livia Rago, Amalia De Curtis, Mariarosaria Persichillo, Francesca Bracone, Marco Olivieri, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, Licia Iacoviello, Maria Benedetta Donati, Giovanni de Gaetano, Jos Vermylen, Ignacio De Paula Carrasco, Simona Giampaoli, Antonio Spagnuolo, Deodato Assanelli, Vincenzo Centritto, Pasquale Spagnuolo, Dante Staniscia, Francesco Zito, Americo Bonanni, Chiara Cerletti, Amalia De Curtis, Augusto Di Castelnuovo, Licia Iacoviello, Roberto Lorenzet, Antonio Mascioli, Marco Olivieri, Domenico Rotilio, Augusto Di Castelnuovo, Marialaura Bonaccio, Simona Costanzo, Francesco Gianfagna, Marco Olivieri, Maurizio Giacci, Antonella Padulo, Dario Petraroia, Amalia De Curtis, Federico Marracino, Maria Spinelli, Christian Silvestri, Americo Bonanni, Marialaura Bonaccio, Francesca De Lucia, Francesco Gianfagna, Branislav Vohnout, Franco Zito, Mariarosaria Persichillo, Angelita Verna, Maura Di Lillo, Irene Di Stefano, Agostino Pannichella, Antonio Rinaldo Vizzarri, Branislav Vohnout, Agnieszka Pampuch, Antonella Arcari, Daniela Barbato, Francesca Bracone, Simona Costanzo, Carmine Di Giorgio, Sara Magnacca, Simona Panebianco, Antonello Chiovitti, Federico Marracino, Sergio Caccamo, Vanesa Caruso, Livia Rago, Daniela Cugino, Francesco Zito, Francesco Gianfagna, Alessandra Ferri, Concetta Castaldi, Marcella Mignogna, Tomasz Guszcz, Romina di Giuseppe, Paola Barisciano, Lorena Buonaccorsi, Floriana Centritto, Antonella Cutrone, Francesca De Lucia, Francesca Fanelli, Iolanda Santimone, Anna Sciarretta, Maura Di Lillo, Isabella Sorella, Irene Di Stefano, Emanuela Plescia, Alessandra Molinaro, Christiana Cavone, Giovanna Galuppo, Maura Di Lillo, Concetta Castaldi, Dolores D'Angelo, Rosanna Ramacciato, Simona Costanzo, Simona Costanzo, Marco Olivieri, Livia Rago, Simona Costanzo, Amalia de Curtis, Licia Iacoviello, Mariarosaria Persichillo

The aim of this study was to assess the hypothesis that alcohol consumption is associated with onset of atrial fibrillation (AF) and/or heart failure (HF). The connection between ethanol intake and AF or HF remains controversial. The study population was 22,824 AF- or HF-free subjects (48% men, age ≥35 years) randomly recruited from the general population included in the Moli-sani study, for whom complete data on HF, AF, and alcohol consumption were available. The cohort was followed up to December 31, 2015, for a median of 8.2 years (183,912 person-years). Incident cases were identified through linkage to the Molise regional archive of hospital discharges. Hazard ratios were calculated using Cox proportional hazard models and cubic spline regression. A total of 943 incident cases of HF and 554 of AF were identified. In comparison with never drinkers, both former and occasional drinkers showed comparable risk for developing HF. Drinking alcohol in the range of 1 to 4 drinks/day was associated with a lower risk for HF, with a 22% maximum risk reduction at 20 g/day, independent of common confounders. In contrast, no association of alcohol consumption with onset of AF was observed. Very similar results were obtained after restriction of the analyses to regular or only wine drinkers or according to sex, age, social status, or adherence to the Mediterranean diet. Consumption of alcohol in moderation was associated with a lower incidence of HF but not with development of AF.