酒精既不是心源性猝死和/或致命性室性心律失常的危险因素，也不是保护因素：英国生物库中基于人群的具有遗传特征和酒精摄入量的研究。

Alcohol is neither a risk factor nor a protective factor for sudden cardiac death and/or fatal ventricular arrhythmia: A population-based study with genetic traits and alcohol consumption in the UK Biobank.

机构信息

Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Division of Data Science Research, Innovative Biomedical Technology Research Institute, Seoul National University Hospital, Seoul, South Korea.

出版信息

Heart Rhythm. 2024 Oct;21(10):1820-1826. doi: 10.1016/j.hrthm.2024.04.097. Epub 2024 May 1.

DOI:10.1016/j.hrthm.2024.04.097

PMID:38697272

Abstract

BACKGROUND

The association between alcohol consumption and the risk of sudden cardiac death and/or fatal ventricular arrhythmia remains controversial.

OBJECTIVE

We analyzed the association between alcohol consumption, genetic traits for alcohol metabolism, and the risk of sudden cardiac death and/or fatal ventricular arrhythmia.

METHODS

We identified 397,164 individuals enrolled between 2006 and 2010 from the UK Biobank database and followed them until 2021. Alcohol consumption was categorized as current nondrinkers (nondrinkers and ex-drinkers), mild drinkers, moderate drinkers, or heavy drinkers. Genetic traits of alcohol metabolism were stratified according to the polygenic risk score tertiles. The primary and secondary outcomes were a composite of sudden cardiac death and fatal ventricular arrhythmia as well as their individual components.

RESULTS

During follow-up (median 12.5 years), 3543 cases (0.89%) of clinical outcomes occurred. Although mild, moderate, and heavy drinkers showed deceased risks of outcomes compared with current nondrinkers, there was no prognostic difference among nondrinkers, mild drinkers, moderate drinkers, and heavy drinkers. Ex-drinkers showed an increased risk in univariate analysis, but the significance was attenuated after adjusting covariates (hazard ratio 1.19; 95% confidence interval 0.94-1.50). As a continuous variable, alcohol consumption was not associated with clinical outcomes (hazard ratio 1.01; 95% confidence interval 0.99-1.02). Consistent with these findings, there was no association between genetic traits for alcohol metabolism and the risk of clinical outcomes.

CONCLUSION

Alcohol consumption was neither a protective factor nor a risk factor for sudden cardiac death or fatal ventricular arrhythmia. Genetic traits of alcohol metabolism were not associated with the clinical prognosis.

摘要

背景

饮酒与心源性猝死和/或致命性室性心律失常风险之间的关联仍存在争议。

目的

我们分析了饮酒、酒精代谢遗传特征与心源性猝死和/或致命性室性心律失常风险之间的关系。

方法

我们从英国生物库数据库中确定了 2006 年至 2010 年间招募的 397164 名个体，并对其进行随访至 2021 年。饮酒情况分为当前非饮酒者（非饮酒者和曾饮酒者）、轻度饮酒者、中度饮酒者或重度饮酒者。根据多基因风险评分三分位数对酒精代谢的遗传特征进行分层。主要和次要结局是心源性猝死和致命性室性心律失常的复合终点以及它们的单独组成部分。

结果

在随访期间（中位时间 12.5 年），发生了 3543 例（0.89%）临床结局事件。尽管轻度、中度和重度饮酒者与当前非饮酒者相比，结局风险降低，但非饮酒者、轻度饮酒者、中度饮酒者和重度饮酒者之间没有预后差异。在单变量分析中，曾饮酒者的风险增加，但在调整协变量后，其显著性减弱（风险比 1.19；95%置信区间 0.94-1.50）。作为连续变量，饮酒与临床结局无关（风险比 1.01；95%置信区间 0.99-1.02）。与这些发现一致的是，酒精代谢的遗传特征与临床结局风险之间没有关联。