Patterns of Alcohol Consumption and Myocardial Infarction Risk: Observations From 52 Countries in the INTERHEART Case-Control Study

• Published in: Circulation (New York, N.Y.) Vol. 130; no. 5; pp. 390 - 398
• Main Authors: LEONG, Darryl P, SMYTH, Andrew, TEO, Koon K, MCKEE, Martin, RANGARAJAN, Sumathy, PAIS, Prem, LISHENG LIU, ANAND, Sonia S, YUSUF, Salim
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 29.07.2014
• Subjects: Age Distribution; Aged; Alcohol Drinking - epidemiology; Binge Drinking - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Case-Control Studies; Continental Population Groups - statistics & numerical data; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Global Health - statistics & numerical data; Heart; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Myocardial Infarction - epidemiology; Myocarditis. Cardiomyopathies; Odds Ratio; Prevalence; Risk Factors; Risk Reduction Behavior; Sex Distribution; Consumption; Myocardial infarction; risk factors; Countries; Cardiovascular disease; Risk; Case control study; Coronary heart disease; Myocardial disease; Epidemiology; alcohol drinking; Alcoholic beverage; Risk factor; Observation; Circulatory system; Cardiology; Public health; epidemiology; myocardial infarction
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.113.007627

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. 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). 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.