Drinking Frequency, Mediating Biomarkers, and Myocardial Infarction

To examine the associations between drinking frequency and the risk of myocardial infarction (MI), researchers analyzed data from 32,826 female and 18,225 male participants of 2 large cohort studies. A total of 515 subjects with incident MI were matched to 1030 controls on sex, age, smoking, and date of study entry.

• Drinking at least 3–4 days per week was associated with a lower risk of MI in both men and women.
• In adjusted analyses, high-density lipoprotein (HDL) cholesterol, hemoglobin A1c, and fibrinogen accounted for 75% of the association between drinking frequency and MI risk in women and 100% of the association in men.

Comments:

Like other studies, this study found that drinking frequency is associated with a lower risk of MI in both men and women. The authors state that the attenuated results in analyses adjusted for HDL cholesterol, hemoglobin A1c, and fibrinogen—3 biomarkers beneficially affected by alcohol—suggest that alcohol may in fact have a causal role. This role may be largely—or even entirely— mediated by these factors. However, whether alcohol truly decreases MI risk can only be determined through long-term randomized trials.

R. Curtis Ellison, MD

Reference:

Mukamal KJ, Majken KJ, Grønbæk M, et al. Drinking frequency, mediating biomarkers, and risk of myocardial infarction in women and men. Circulation. 2005;112(10):1406–1413.