Practice Update
Research · June 13, 2014
TAKE-HOME MESSAGE
- In 12,195 patients with first myocardial infarction (MI) and 15,583 age- and sex-matched controls from 52 countries, the current use of alcohol was associated with a significantly reduced risk for MI compared with the risk for non-users (P = .001), although the strength of the association varied across geographic regions. Drinking ≥6 drinks in the previous 24 hours was associated with a significantly increased risk for MI (P = .01), especially in individuals >65 years of age (P = .008).
- Results showed that, while light alcohol use is associated with a small reduction in the risk for MI, heavy drinking increases MI risk.
ABSTRACT
BACKGROUND
While 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 negates 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 to non-users, adjusted odds ratio 0.87; 95% CI 0.80-0.94, p=0.001), however the strength of this assocation 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% CI 1.1-1.9, p=0.01). This risk was particularly elevated in older individuals (for age >65 years, odds ratio 5.3; 95% CI 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.
Circulation
Patterns of Alcohol Consumption and Myocardial Infarction Risk: Observations From 52 Countries in the INTERHEART Case-Control Study