Alcohol and Immediate Risk of Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis.
Alcohol and Immediate Risk of Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis.
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DOI：
10.1161/circulationaha.115.019743
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发表时间：
2016-03-08
期刊：
影响因子：
37.8
通讯作者：
Mittleman MA
中科院分区：
文献类型：
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作者：
Mostofsky E;Chahal HS;Mukamal KJ;Rimm EB;Mittleman MA
尽管大量研究描述了习惯性中度和重度饮酒对心血管的影响，但饮酒后的直接风险尚未得到很好的表征。基于其生理效应，酒精可能对短期和长期风险产生明显不同的影响。我们检索了CINAHL、Embase和PubMed从开始到2015年3月12日的数据，并辅以人工筛选，以评估酒精摄入量与随后几小时和几天内心血管事件之间的相关性。我们使用DerSimonian和Laird随机效应模型计算了酒精摄入与心肌梗死（MI）、缺血性卒中（IS）和出血性卒中（HS）之间相关性的合并相对危险度（RR）和95%置信区间（CI），以模拟任何酒精摄入或酒精摄入与心血管事件的剂量反应关系。在1056篇引文和37篇综述的全文文章中，纳入了23项研究（29457例受试者）。适度饮酒与立即较高的心血管风险相关，2 - 4小时后减弱，甚至对MI和HS具有保护作用（102 -4杯：RR=风险降低30%），并在一周内保护IS（106杯：风险降低19%）。相比之下，大量饮酒与第二天（206 -9杯：RR=1.3-2.3）和第二周（2019 -30杯：RR=2.25-6.2）的心血管风险较高相关。似乎有一个一致的发现，即在任何饮酒后立即增加心血管风险，但到24小时，只有大量饮酒才能带来持续的风险。
Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol consumption, the immediate risks following alcohol intake have not been well characterized. Based on its physiological effects, alcohol may have markedly different effects on immediate and long-term risk. We searched CINAHL, Embase, and PubMed from inception to March 12 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs) for the association between alcohol intake and myocardial infarction (MI), ischemic stroke (IS) and hemorrhagic stroke (HS) using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events. Among 1056 citations and 37 full-text articles reviewed, 23 studies (29457 participants) were included. Moderate alcohol consumption was associated with an immediately higher cardiovascular risk that was attenuated after 24 hours, and even protective for MI and HS (≈2–4 drinks: RR=30% lower risk), and protective against IS within one week (≈6 drinks: 19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (≈6–9 drinks: RR=1.3–2.3) and week (≈19–30 drinks: RR=2.25–6.2). There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption but by 24 hours, only heavy alcohol intake conferred continued risk.