Alcohol abuse may up arrhythmia mortality risk

Individuals hospitalized with arrhythmia may have an increased risk of in-hospital mortality if they have a history of alcohol abuse, according to a study presented at BCVS* 2020.

Using the Nationwide Inpatient Sample database, the authors identified 114,958 patients aged 15–54 years who had been hospitalized for arrhythmia between 2010 and 2014. Of these, 9.75 percent had comorbid alcohol abuse defined as alcohol consumption that causes problems at home, work, or school, regardless of whether there exists a physical dependency on alcohol. The prevalence of alcohol abuse was higher among men (85.9 percent), Caucasians (69 percent), and older adults (aged 45–54 years; 68 percent).

After adjusting for demographics and cardiovascular comorbidities, individuals with a history of alcohol abuse had a higher risk of in-hospital mortality than those who did not consume alcohol (1.9 percent vs 1.4 percent; odds ratio [OR], 1.7, 95 percent confidence interval [CI], 1.4–2.1). [BCVS 2020, abstract 484]

In general, in-hospital mortality among arrhythmia patients was lower in men than women (OR, 0.8, 95 percent CI, 0.7–0.9). Increasing age was tied to an increasing risk of mortality with individuals aged 45–54 years having a twofold risk (95 percent CI, 1.5–3.1) compared with younger individuals.

Individuals with arrhythmia who also had atherosclerosis were at higher risk of in-hospital mortality (OR, 4.5, 95 percent CI, 3.4–5.9), as were those with diabetes (OR, 1.4, 95 percent CI, 1.2–1.7).

“Alcohol abuse has harmful effects on physical health, leading to more illness and death in patients with heart problems. This is the first study to explore whether alcohol abuse is a risk factor for death in patients hospitalized with arrhythmia,” noted lead author Dr Rikinkumar Patel from Griffin Memorial Hospital in Norman, Oklahoma, US.

“[In this study,] alcohol abuse independently increase[d] the risk of mortality by 72 percent in arrhythmia inpatients,” he said.

“Physicians should educate patients with alcohol problems about their risk of hospitalization for arrhythmia and their increased risk of death. Integrated care models need to be developed to formulate strategies to counter problematic alcohol use [eg, reduce alcohol consumption or promote abstinence] and improve the health-related quality of life of patients,” he added.

Patel and co-authors acknowledged several study limitations including the inability to establish cause and effect of alcohol abuse and arrhythmia-related mortality, as well as the potential association in individuals older than 54 years. They also called attention to the need for further research into identifying if social alcohol consumption could affect individuals with arrhythmia who do not abuse alcohol.