Low-to-moderate alcohol consumption not associated with strokes in people with atrial fibrillation

In patients with atrial fibrillation, low-to-moderate alcohol consumption was not associated with an increased risk of stroke, found new research in CMAJ (Canadian Medical Association Journal)

Atrial fibrillation, a common type of irregular heartbeat, can lead to stroke. Alcohol use is also a risk factor for stroke, can increase the risk of bleeding and may interfere with adherence to certain medications used in patients with atrial fibrillation, such as blood thinners. For these reasons, many physicians recommend complete alcohol avoidance in people with this heart condition. However, this guidance is largely based on expert opinion rather than strong evidence.

To fill this evidence gap, researchers looked at data on 3852 patients with atrial fibrillation in Switzerland to determine whether alcohol consumption was linked to an increase in stroke or bleeding. The mean age of participants was 71 years, 28 per cent were women and 84 per cent were taking blood thinners.

“[W]e found no significant association between alcohol consumption and risk of stroke or systemic embolism. Alcohol consumption was not associated with an increased risk of bleeding, despite most participants receiving oral anticoagulation for stroke prevention,” writes Dr. David Conen, McMaster University, Hamilton, Ontario, and the Cardiovascular Research Institute Basel, Basel, Switzerland, with coauthors.

They state that the findings are reassuring, especially as patients with atrial fibrillation tend to be older and have multiple health conditions.

“Our findings do not support special recommendations for patients with established [atrial fibrillation] with regard to alcohol consumption,” they conclude.

“Alcohol consumption and risk of cardiovascular outcomes and bleeding in patients with established atrial fibrillation” is published January 25, 2021.