Association of alcohol consumption with circulating biomarkers of atrial fibrillation-related pathways in a population at high cardiometabolic risk

• Type of Material: Article
• Authors: Aniqa Bushra Alam, Emory University; Estefania Toledo-Atucha, Carlos III Health Institute; Dora Romaguera, Carlos III Health Institute; Angel M. Alons-Gomez, Carlos III Health Institute; Miguel A. Martinez-Gonzalez, Carlos III Health Institute; Lucas Tojal-Sierra, Navarra’s Health Research Institute; Cristina Razquin, Carlos III Health Institute; Marta Noris Mora, Health Research Institute of the Balearic Islands; Linzi Li, Emory University; Vinita Subramanya, Emory University; Jordi Salas-Salvado, Carlos III Health Institute; Montserrat Fito, Carlos III Health Institute; Alvaro Alonso, Emory University
• Language: English
• Date: 2023-12-05
• Publisher: Cold Spring Harbor Laboratory
• Publication Version: Preprint (Prior to Peer Review)
• Copyright Statement: The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://www.medrxiv.org/content/10.1101/2023.12.05.23299449v1
• Title of Journal or Parent Work: medRxiv
• Grant/Funding Information: This study was supported by NIH/NHLBI under award number R01HL137338 and K24HL148521. The PREDIMED-Plus trial was supported by the European Research Council (Advanced Research Grant 2014–2014, number 340918 awarded to M.A.M.-G. as principal investigator of the trial), and by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III ([Carlos III Health Institute], Sevilla, Spain), through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/0147, PI14/00636, PI14/00972, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158, the Recercaixa grant 2013ACUP00194, grants from the Consejería de Salud de la Junta de Andalucía PI0458/2013; PS0358/2016, PI0137/2018, the PROMETEO/2017/017 grant from the Generalitat Valenciana, the SEMERGEN grant and FEDER funds CB06/03.
• Keywords: metabolically unhealthy adults; PICP; biomarkers; weight-loss; atrial fibrillation risk; NTproBNP; hsCRP; alcohol consumption; 3-nitrotyrosine; hsTnT; cardiovascular health
• Research Categories: Health Sciences, Public Health

Abstract

Background The effect of alcohol consumption on cardiovascular health, including atrial fibrillation risk, remains controversial. Evaluating the association of alcohol consumption with circulating atrial fibrillation-related biomarkers may help better understand the relevant mechanistic underpinnings. Methods We studied 523 participants from 3 sites for the PREDIMED-Plus study, a weight-loss randomized intervention trial in metabolically unhealthy adults. N-terminal pro-B-type natriuretic protein (NTproBNP), high sensitivity troponin-T (hsTnT), high-sensitivity C-reactive protein (hsCRP), 3-nitrotyrosine (3-NT), and procollagen type 1 carboxy-terminal propeptide (PICP) were measured in fasting serum samples at baseline and years 3 and 5 of follow-up. We calculated alcohol consumption in drinks/day (1 drink = 14 grams alcohol) with validated food frequency questionnaires at each visit. Using multiple linear regression and mixed models we estimated the association of alcohol consumption with log-transformed biomarkers at baseline and longitudinally adjusting for potential confounders. Results Among 523 participants (mean age: 65 years, 40% female), mean alcohol consumption was 1 drink/day. Cross-sectionally, alcohol consumption was not associated with cardiac biomarker concentrations. Longitudinally, compared to non-consumers, heavy drinkers (≥4 drinks/day) had smaller increases in hsTnT (β: −0.11, 95%CI: −0.20, −0.01)and PICP (β: −0.15, 95%CI: −0.30, 0.01) over the 5-year follow-up. In contrast, those who increased alcohol consumption over the 5-year period experienced greater increases in hsCRP (β: 0.42, 95%CI: 0.11, 0.73) compared to those whose drinking behavior stayed the same. Conclusion Alcohol consumption was associated with complex changes in circulating biomarkers, including comparatively lower fibrotic and myocardial damage, but higher levels of overall inflammation over time. These results underscore the need for further research to better understand the effects of alcohol on cardiovascular health.