Association of smoking, alcohol, and obesity with cardiovascular death and ischemic stroke in atrial fibrillation Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke and cardiovascular (CV) death. This study looked at modifiable lifestyle risk factors such as smoking, alcohol and obesity and their associated with atrial fibrillation and cardiovascular outcomes.
Among the Atherosclerosis Risk in Communities (ARIC) study and Cardiovascular Health Study (CHS) participants with incident Atrial Fibrilation, the study authors estimated the risk of composite endpoint of ischemic stroke or CV death associated with candidate modifiable risk factor (smoking, heavy alcohol consumption, or high body mass index [BMI]), and computed the C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) of incorporating each factor into the CHA2DS2-VASc.
Among 1,222 ARIC participants with incident AF (mean age: 63.4) and 756 CHS participants with incident AF (mean age: 79.1), there were 332 and 335 composite events respectively during mean followup of 6.9 years and 5.7 years. Compared with never smokers, current smokers had a higher incidence of the composite endpoint in ARIC [HR: 1.65 (1.21– 2.26)] but not in CHS [HR: 1.05 (0.69–1.61)]. No significant associations were observed with alcohol consumption or BMI with Cardiovascular death outcomes in Atrial Fibrilations patients from either cohort.
The authors conclude that smoking is associated with an increased risk of ischemic stroke or CV death in at risk populations, which comprised mostly of middleaged to young-old (65–74 years), but not in the Cardiovascular Heart Study cohort, which comprised mostly middle-old or oldest-old (≥75 years) adults with Atrial Fibrilation. However, addition of smoking to the CHA2DS2-VASc score did not improve risk prediction of these outcomes.
Source: Association of smoking, alcohol, and obesity with cardiovascular death and ischemic stroke in atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study and Cardiovascular Health Study (CHS). Kwon Y, Norby FL, Jensen PN, Agarwal SK, Soliman EZ, Lip GY, Longstreth WT Jr, Alonso A, Heckbert SR3, Chen LY. PLoS One. 2016 Jan 12;11(1).