Alcohol Consumption Increases the Risk of Acute Myocardial Infarction in the Next 12 Hours

Regular moderate alcohol consumption may be a protective factor for cardiovascular disease. However, the effect of alcohol consumption immediately prior to cardiovascular events has not been studied extensively. Researchers conducted a “case-crossover” study in 250 first-time nonfatal acute myocardial infarction (AMI) cases to assess the influence of alcohol consumption in the 12 hours preceding AMI. Each case served as its own control; i.e., the control information for each subject was based on his or her own past behavior. The 12 hours preceding AMI was considered the hazard period, while the corresponding time period a week before AMI was the control period.

• Drinking any alcohol in the hazard period increased the risk for AMI threefold (odds ratio [OR], 3.1); even moderate drinking (≤24 g of ethanol for women and ≤36 g for men) more than doubled it (OR, 2.3).

• Of the 187 subjects who drank any alcohol, 15 men and 2 women reported heavy episodic drinking (4+ drinks per occasion for women and 5+ drinks for men). The association between heavy episodic drinking and AMI was not significant (OR, 3.0).

• These results were not influenced by known risk factors for AMI (age, gender, smoking status, family history of AMI, hypertension, hyperlipidemia, diabetes, prior unstable angina pectoris, physical exertion shortly before the event, psychological stress, or cocaine use) in adjusted analyses.

• Compared with an age- and sex-matched general population sample, subjects with AMI had more frequent heavy episodic drinking (less than monthly, 21% versus 11%; monthly or more, 7% versus 3%) and were more likely to drink irregularly, i.e., less than weekly (29% versus 16%).

Comments:

Drinking any alcohol increased the risk for AMI in the next 12 hours in this study. Researchers were not
able to demonstrate a significant association between heavy episodic drinking and AMI due to the small number of exposed subjects; however, the sample had higher rates of heavy and irregular drinking compared with the general population, giving some support to the hypotheses that heavy drinking increases AMI risk, and that pattern of drinking is important when assessing the risk for cardiovascular events. The relationship between alcohol use and cardiovascular events is likely not as simple as is commonly thought.

Nicolas Bertholet, MD, MPH

Reference:

Gerlich MG, Krämer A, Gmel G, et al. Patterns of alcohol consumption and acute myocardial infarction: a case-crossover analysis. Eur Addict Res. 2009;15(3):143–149.