Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
JAMA Netw Open. 2022 Sep 1;5(9):e2229799. doi: 10.1001/jamanetworkopen.2022.29799.
Guidelines recommend that all risk factors for early-onset atrial fibrillation, including lifestyle factors, be proactively managed, considering the poor prognosis of the disease. Not much is known about the association of cumulative alcohol intake with the risk of atrial fibrillation in young adults aged 20 to 39 years, especially among heavy drinkers.
To explore the association of alcohol consumption with the risk of incident atrial fibrillation in young adults.
DESIGN, SETTING, AND PARTICIPANTS: Using the National Health Insurance Service database, a nationwide population-based cohort study of adults aged 20 to 39 years without prior atrial fibrillation who underwent 4 serial annual health examinations between 2009 and 2012 was conducted. The cumulative alcohol consumption burden over 4 years was calculated by assigning 1 point to more than moderate drinking (≥105 g of alcohol per week) each year. Additionally, a semiquantitative cumulative burden was calculated by assigning 0, 1, 2, and 3 points to non, mild (<105 g per week), moderate (105-210 g per week), and heavy (≥210 g per week) drinking, respectively. Data were analyzed from May to June 2021.
Amount of alcohol intake in 4 years.
The primary outcome was incident atrial fibrillation during the follow-up period.
A total of 1 537 836 participants (mean [SD] age 29.5 [4.1] years, 1 100 099 [71.5%] male) were included in the final analysis. According to the 4-year cumulative burden of alcohol consumption stratified by moderate to heavy drinking, 889 382 participants (57.8%) were in the burden 0 group, 203 374 participants (13.2%) in the burden 1 group, 148 087 participants (9.6%) in the burden 2 group, 144 023 participants (9.4%) in the burden 3 group, and 152 970 participants (9.9%) in the burden 4 group. During a median (IQR) follow-up of 6.13 (4.59-6.48) years, atrial fibrillation was newly diagnosed in 3066 participants (0.36 per 1000 person-years). Participants with a cumulative burden of 4 points who continued more than moderate drinking for 4 years showed a 25% higher risk of atrial fibrillation compared with 0-point participants who kept non-to-mild drinking over 4 years (adjusted HR, 1.25; 95% CI, 1.12-1.40). In a semiquantitative analysis, participants who sustained heavy drinking for 4 consecutive years were associated with a 47% higher atrial fibrillation risk than those who remained nondrinkers over 4 years (aHR, 1.47, CI 1.18-1.83).
Persistent moderate to heavy drinking and higher cumulative alcohol consumption burden might increase the risk of atrial fibrillation even in young adults aged 20 to 39 years.
指南建议积极管理所有早发性心房颤动的风险因素，包括生活方式因素，考虑到该疾病的预后不良。对于 20 至 39 岁的年轻人中累积饮酒量与心房颤动风险之间的关联，人们知之甚少，尤其是在大量饮酒者中。
探讨饮酒与年轻人心房颤动发病风险的关系。
设计、地点和参与者：利用国民健康保险服务数据库，对 2009 年至 2012 年期间接受了 4 次年度健康检查且无既往心房颤动的 20 至 39 岁成年人进行了一项全国性基于人群的队列研究。4 年来的累积酒精摄入量负担通过每年给超过适度饮酒（≥105 克酒精/周）记 1 分来计算。此外，通过给非饮酒、轻度（<105 克/周）、中度（105-210 克/周）和重度（≥210 克/周）饮酒分别记 0、1、2 和 3 分来计算半定量累积负担。数据于 2021 年 5 月至 6 月进行分析。
4 年内饮酒量。
主要结局是随访期间新发心房颤动。
共纳入 1537836 名参与者（平均[标准差]年龄 29.5[4.1]岁，1100099[71.5%]男性）进行最终分析。根据 4 年的中度至重度饮酒累积负担进行分层，889382 名参与者（57.8%）处于负担 0 组，203374 名参与者（13.2%）处于负担 1 组，148087 名参与者（9.6%）处于负担 2 组，144023 名参与者（9.4%）处于负担 3 组，152970 名参与者（9.9%）处于负担 4 组。在中位（IQR）随访 6.13（4.59-6.48）年期间，有 3066 名参与者（0.36/1000人年）新诊断出心房颤动。与 4 年保持非至轻度饮酒的 0 分参与者相比，持续 4 年累积 4 分且继续过量饮酒的参与者心房颤动风险增加 25%（校正 HR，1.25；95%CI，1.12-1.40）。在半定量分析中，与 4 年持续不饮酒的参与者相比，持续 4 年重度饮酒的参与者心房颤动风险增加 47%（校正 HR，1.47，CI 1.18-1.83）。
持续的中度至重度饮酒和更高的累积饮酒量负担可能会增加 20 至 39 岁年轻人的心房颤动风险。
