适量饮酒与心力衰竭风险降低相关，但与心房颤动无关。

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

机构信息

Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy.

出版信息

JACC Heart Fail. 2017 Nov;5(11):837-844. doi: 10.1016/j.jchf.2017.08.017. Epub 2017 Oct 11.

DOI:10.1016/j.jchf.2017.08.017

PMID:29032141

Abstract

OBJECTIVES

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).

BACKGROUND

The connection between ethanol intake and AF or HF remains controversial.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Consumption of alcohol in moderation was associated with a lower incidence of HF but not with development of AF.

摘要

目的

本研究旨在评估以下假设，即饮酒与心房颤动（AF）和/或心力衰竭（HF）的发生有关。

背景

乙醇摄入与 AF 或 HF 之间的联系仍存在争议。

方法

研究人群为 22824 例无 AF 或 HF 的受试者（48%为男性，年龄≥35 岁），他们是从莫利萨尼研究中的一般人群中随机招募的，这些受试者完整的数据均包括 HF、AF 和酒精摄入情况。该队列随访至 2015 年 12 月 31 日，中位随访时间为 8.2 年（183912 人年）。通过与莫利塞地区医院出院档案的链接来确定新发病例。使用 Cox 比例风险模型和三次样条回归计算风险比。

结果

共确定了 943 例新发 HF 病例和 554 例新发 AF 病例。与从不饮酒者相比，既往饮酒者和偶尔饮酒者发生 HF 的风险相似。饮酒 1 至 4 杯/天与 HF 风险降低相关，每日 20g 酒精可最大降低 22%的风险，这与常见混杂因素无关。相比之下，饮酒与 AF 的发生无关联。在将分析限制为常规或仅饮用葡萄酒者，或根据性别、年龄、社会地位或遵循地中海饮食进行分析时，也得到了非常相似的结果。