期刊
CIRCULATION
卷 130, 期 5, 页码 390-398出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.113.007627
关键词
alcohol drinking; epidemiology; myocardial infarction; risk factors
资金
- Michael G. DeGroote Fellowship Award, McMaster University
- Heart and Stroke Michael G. DeGroote Chair in Population Health Research
- Canada Research Chair in Ethnicity and Cardiovascular Disease
- Marion Burke Chair of the Heart and Stroke foundation of Canada
- Canadian Institutes of Health Research
- Heart and Stroke Foundation of Ontario
- International Clinical Epidemiology Network
- AstraZeneca
- Novartis
- Aventis
- Abbott
- Bristol Myers Squibb
- King Pharma
- Sanofi-Sythelabo
Background-Although moderate alcohol use is associated with protection against myocardial infarction (MI), it is not known whether this effect is generalizable to populations worldwide. It is also uncertain whether differences in the pattern of alcohol use (and in particular heavy episodic consumption) between different regions negate any beneficial effect. Methods and Results-We included 12 195 cases of first MI and 15 583 age-and sex-matched controls from 52 countries. Current alcohol use was associated with a reduced risk of MI (compared with nonusers: adjusted odds ratio, 0.87; 95% confidence interval, 0.80-0.94; P=0.001); however, the strength of this association was not uniform across different regions (region-alcohol interaction P<0.001). Heavy episodic drinking (=6 drinks) within the preceding 24 hours was associated with an increased risk of MI (odds ratio, 1.4; 95% confidence interval, 1.1-1.9; P=0.01). This risk was particularly elevated in older individuals (for age >65 years: odds ratio, 5.3; 95% confidence interval, 1.6-18; P=0.008). Conclusions-In most participants, low levels of alcohol use are associated with a moderate reduction in the risk of MI; however, the strength of this association may not be uniform across different countries. An episode of heavy drinking is associated with an increased risk of acute MI in the subsequent 24 hours, particularly in older individuals.
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