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 UK Biobank.

BACKGROUND: The association between alcohol consumption and 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 subjects 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 the follow-up (median 12.5 years), 3,543 cases of clinical outcomes occurred. Although mild, moderate, and heavy drinkers showed deceased risks of outcomes compared with current non-drinkers, there was no prognostic difference among non-drinkers, mild drinkers, moderate drinkers, and heavy drinkers. Ex-drinkers showed increased risk in the univariate analysis, but the significance was attenuated after adjusting covariates (hazard ratio (HR) 1.19; 95% confidence interval [CI]: 0.94-1.50). As a continuous variable, alcohol consumption was not associated with clinical outcomes (HR 1.01; 95% CI 0.99-1.02). Consistent with these findings, there was no association between genetic traits for alcohol metabolism, and the risk of clinical outcomes.

CONCLUSIONS: Alcohol consumption was neither a protective nor a risk factor for sudden cardiac death or fatal ventricular arrhythmia. Genetic traits of alcohol metabolism were not associated with the clinical prognosis.