Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge (J.L.H., L.-C.W., S.H.C., S.J.J., V.N.M., S.K., P.T.E., S.A.L.).
Department of Medicine (J.L.H.), Massachusetts General Hospital.
Circ Genom Precis Med. 2020 Dec;13(6):e003111. doi: 10.1161/CIRCGEN.120.003111. Epub 2020 Nov 6.
Excess alcohol intake and inherited predisposition may increase risk of atrial fibrillation (AF). We assessed the association between alcohol intake, polygenic predisposition to AF, and incident AF in the UK Biobank, a prospective cohort study.
In 376 776 UK Biobank participants enrolled between 2006 and 2010, we tested alcohol consumption (stratified by the Centers of Disease Control and Prevention acceptable range of ≤98 g/wk for women or ≤196 g/wk for men; and as a continuous variable) and an AF polygenic risk score for association with incident AF.
Among participants (47.5% male, mean age 56.9 years), 6293 developed AF during a median of 6.9 years of follow-up. Alcohol consumption was associated with AF (hazard ratio, 1.10 [95% CI, 1.05-1.16] for intake above an acceptable range; hazard ratio, 1.04 per 100 g/wk [95% CI, 1.02-1.06]). An AF polygenic risk score was associated with AF (hazard ratio, 1.38 per SD [95% CI, 1.35-1.41]). In models including both alcohol and the AF polygenic risk score, each remained associated with AF. The 5-year cumulative risk of AF for individuals with alcohol intake above an acceptable range and in the highest decile of polygenic risk was 2.33% (95% CI, 2.07-2.59), compared with 0.69% (95% CI, 0.58-0.80) for those with alcohol intake within an acceptable range and in the lowest decile of polygenic risk.
Alcohol consumption is associated with increased risk of AF across a range of polygenic predisposition to AF and adds to inherited and clinical predisposition to increase AF susceptibility. Preventive efforts focused on minimizing alcohol intake may be broadly applicable.
过量饮酒和遗传易感性可能会增加心房颤动（AF）的风险。我们在英国生物库中评估了饮酒量、AF 的多基因易感性与房颤事件之间的关系，英国生物库是一项前瞻性队列研究。
在 2006 年至 2010 年间招募的 376776 名英国生物库参与者中，我们检测了酒精摄入量（按疾病控制与预防中心可接受范围（女性≤98 克/周，男性≤196 克/周）分层，以及作为一个连续变量）和房颤多基因风险评分与房颤事件的相关性。
在参与者中（47.5%为男性，平均年龄 56.9 岁），中位随访 6.9 年后有 6293 人发生房颤。饮酒与房颤相关（风险比，1.10[95%CI，1.05-1.16]；每增加 100 克/周，风险比为 1.04[95%CI，1.02-1.06]）。房颤多基因风险评分与房颤相关（风险比，每增加一个标准差为 1.38[95%CI，1.35-1.41]）。在包括饮酒和房颤多基因风险评分的模型中，两者都与房颤相关。饮酒量超过可接受范围和多基因风险最高十分位数的个体在 5 年内房颤累积风险为 2.33%（95%CI，2.07-2.59），而饮酒量在可接受范围内和多基因风险最低十分位数的个体为 0.69%（95%CI，0.58-0.80）。
饮酒与多种房颤多基因易感性相关，增加了房颤的风险，增加了遗传和临床易感性，增加了房颤的易感性。以尽量减少饮酒量为重点的预防措施可能具有广泛的适用性。
