Alcohol Abuse and Cardiac Disease.
Alcohol Abuse and Cardiac Disease.
复制标题
DOI：
10.1016/j.jacc.2016.10.048
复制
发表时间：
2017-01-03
影响因子：
24
通讯作者：
Marcus GM
中科院分区：
文献类型：
--
作者：
Whitman IR;Agarwal V;Nah G;Dukes JW;Vittinghoff E;Dewland TA;Marcus GM
了解酒精滥用（一种常见的理论上可以改变的疾病）与世界上最常见的死亡原因心血管疾病之间的关系，可以为潜在的预防策略提供信息。探讨酒精滥用与心房颤动（AF）、心肌梗死（MI）和充血性心力衰竭（CHF）的关系。使用医疗保健成本和利用项目数据库，我们对2005年至2009年期间在加州接受门诊手术、急诊或住院医疗护理的加州≥21岁居民进行了纵向分析。我们确定了酒精滥用诊断对AF、MI和CHF事件的风险。确定了改变相关性的患者特征和人群归因风险。在14，727，591例患者中，268，084例（1.8%）有酒精滥用。多变量校正后，酒精滥用与AF（HR 2.14，95% CI 2.08-2.19，P<0.0001）、MI（HR 1.45，95% CI 1.40-1.51，P <0.0001）和CHF（HR 2.34，95% CI 2.29-2.39，P<0.0001）事件风险增加相关。在相互作用分析中，没有心血管疾病传统危险因素的个体表现出不成比例的每种结局的风险增加。酒精滥用对每个结果的人群归因风险与其他公认的可改变的风险因素相似。酒精滥用增加AF、MI和CHF风险的程度与其他已确定的风险因素相似。那些没有传统心血管危险因素的人在酗酒的情况下更容易患上这些心脏病。因此，努力减少酒精滥用可能会导致心血管疾病的显着减少。
Understanding the relationship between alcohol abuse, a common and theoretically modifiable condition, and the most common cause of death in the world, cardiovascular disease, may inform potential prevention strategies. To investigate the associations between alcohol abuse and atrial fibrillation (AF), myocardial infarction (MI), and congestive heart failure (CHF). Using the Healthcare Cost and Utilization Project database, we performed a longitudinal analysis of California residents ≥21 years old who received ambulatory surgery, emergency, or inpatient medical care in California between 2005 and 2009. We determined the risk of an alcohol abuse diagnosis on incident AF, MI, and CHF. Patient characteristics modifying the associations and population attributable risks were determined. Among 14,727,591 patients, 268,084 (1.8%) had alcohol abuse. After multivariable adjustment, alcohol abuse was associated with an increased risk of incident AF (HR 2.14, 95% CI 2.08–2.19, P<0.0001), MI (HR 1.45, 95% CI 1.40–1.51, P <0.0001), and CHF (HR 2.34, 95% CI 2.29–2.39, P<0.0001). In interaction analyses, individuals without conventional risk factors for cardiovascular disease exhibited a disproportionately enhanced risk of each outcome. The population attributable risk of alcohol abuse on each outcome was of similar magnitude to other well-recognized modifiable risk factors. Alcohol abuse increased the risk of AF, MI, and CHF to a similar degree as other well-established risk factors. Those without traditional cardiovascular risk factors are disproportionately prone to these cardiac diseases in the setting of alcohol abuse. Thus, efforts to mitigate alcohol abuse might result in meaningful reductions of cardiovascular disease.