Author + information
- Received June 14, 2017
- Revision received August 1, 2017
- Accepted August 3, 2017
- Published online October 30, 2017.
- Augusto Di Castelnuovo, MSc, PhDa,∗ (, )
- Simona Costanzo, MSc, PhDa,
- Marialaura Bonaccio, MA, PhDa,
- Livia Rago, MDb,
- Amalia De Curtis, BSca,
- Mariarosaria Persichillo, MSca,
- Francesca Bracone, MScb,
- Marco Olivieri, BScb,
- Chiara Cerletti, PhDa,
- Maria Benedetta Donati, MD, PhDa,
- Giovanni de Gaetano, MD, PhDa,
- Licia Iacoviello, MD, PhDa,c,
- on behalf of the Moli-sani Investigators
- aDepartment of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
- bEpicomed Research, Campobasso, Italy
- cDepartment of Medicine and Surgery, University of Insubria, Varese, Italy
- ↵∗Address for correspondence:
Dr. Augusto Di Castelnuovo, Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell’Elettronica, 86077 Pozzilli (Isernia), Italy.
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.
The enrollment phase of the Moli-sani Project was conducted at the Research Laboratories of the Catholic University in Campobasso, Italy; and supported by research grants from the Pfizer Foundation (Rome, Italy), the Italian Ministry of University and Research (Rome, Italy), Programma Triennale di Ricerca, Decreto 1588, and the Instrumentation Laboratory (Milan, Italy). These funders had no role in study design; collection, analysis, and interpretation of data; manuscript preparation; or the decision to submit the manuscript for publication. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 14, 2017.
- Revision received August 1, 2017.
- Accepted August 3, 2017.
- 2017 American College of Cardiology Foundation