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

Chan Soon Park; Jaewon Choi; JungMin Choi; Kyung-Yeon Lee; Hyo-Jeong Ahn; Soonil Kwon; So-Ryoung Lee; Eue-Keun Choi; Soo Heon Kwak; Seil Oh

doi:10.1016/j.hrthm.2024.04.097

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

Heart Rhythm. 2024 May 1:S1547-5271(24)02531-1. doi: 10.1016/j.hrthm.2024.04.097. Online ahead of print.

Authors

Affiliations

¹ Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
² Division of Data Science Research, Innovative Biomedical Technology Research Institute, Seoul National University Hospital, Seoul, South Korea.
³ Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
⁴ Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: seil@snu.ac.kr.

PMID: 38697272
DOI: 10.1016/j.hrthm.2024.04.097

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 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.

Keywords: Alcohol consumption; Arrhythmias, Cardiac; Death, Sudden, Cardiac; Genetic predisposition to disease.