Heavy Drinking & Coronary Disease: Acute/Chronic Effects

酗酒

• 批准号: 6869996
• 负责人: KENNETH Jay MUKAMAL
• 金额: $ 20.19万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-02-01 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6869996
• 关键词: alcoholic beverage consumption; cardiovascular disorder risk; clinical research; coronary disorder; disease /disorder onset; health behavior; human mortality; human subject; longitudinal human study; myocardial infarction; questionnaires

DESCRIPTION (provided by applicant): Heavy episodic drinking has been associated with several adverse health outcomes, but its association with myocardial infarction (MI) remains uncertain, the acute risks of heavy drinking episodes on triggering of MI have not been explored, and the effects of heavy episodic drinking on prognosis of early survivors of MI is unknown. Given the complex relation of alcohol use to coronary heart disease (CHD), these issues are of immediate public health importance and may impact the clinical care of patients with CHD. This proposal aims to assess the effects of heavy episodic drinking at three points on the continuum of CHD: 1. The association of heavy episodic drinking with 16-year risk of incident MI - This aim will be addressed in over 30,000 participants of the Health Professionals Follow-up Study, a prospective cohort study that includes validated measures of alcohol intake and repeatedly updated information on potential confounders. 2. The acute risk of precipitating MI associated with episodes of heavy drinking - This aim will be addressed in the Determinants of MI Onset Study, which enrolled over 3,800 patients hospitalized with confirmed Ml. Using an innovative case-crossover design, this study can compare the frequency with which patients report heavy drinking on the day of MI with their usual frequency of such intake and the frequency on the preceding day. By comparing patients to themselves, the case-crossover design eliminates confounding by factors that differ between, but not within, individuals and accurately quantifies the acute cardiac risk of heavy drinking. 3. The association of heavy episodic drinking with 4-year risk of mortality among patients who survive acute MI - This aim will be conducted in the Onset Follow-up Study, an inception cohort study of the first 1,935 patients in the Determinants of MI Onset Study. This study has rich detail on clinical, demographic, and lifestyle determinants of prognosis among patients with CHD. Taken together, these three components will explore the role of heavy episodic drinking in the development of acute MI - both chronically and acutely - and in the prognosis of patients who survive acute MI. These results may prove to have important biological, clinical, and public health implications for the care of CHD.

描述（由申请人提供）：重度间歇性饮酒与几种不良健康结局相关，但其与心肌梗死（MI）的相关性仍不确定，尚未探索重度饮酒事件触发MI的急性风险，重度间歇性饮酒对MI早期幸存者预后的影响尚不清楚。鉴于酒精使用与冠心病（CHD）的复杂关系，这些问题具有直接的公共卫生重要性，并可能影响CHD患者的临床护理。 该提案旨在评估重度间歇性饮酒对CHD连续性的三个点的影响： 1.重度间歇性饮酒与16年心肌梗死事件风险的相关性-这一目标将在超过30，000名健康专业人员随访研究的参与者中得到解决，这是一项前瞻性队列研究，包括酒精摄入量的验证措施和反复更新的潜在混杂因素信息。 2.与大量饮酒事件相关的诱发MI的急性风险-这一目标将在MI发作的决定因素研究中得到解决，该研究招募了超过3，800名因确诊的MI而住院的患者。 使用创新的病例交叉设计，本研究可以比较患者在MI当天报告大量饮酒的频率与他们通常的摄入频率和前一天的频率。通过将患者与自身进行比较，病例交叉设计消除了个体之间而非个体内部差异因素的混淆，并准确量化了大量饮酒的急性心脏风险。 3.在急性心肌梗死存活患者中，重度间歇性饮酒与4年死亡风险的相关性-这一目标将在发病随访研究中进行，这是一项针对心肌梗死发病决定因素研究中前1，935例患者的初始队列研究。这项研究对冠心病患者的临床、人口统计学和生活方式预后决定因素有丰富的细节。 总之，这三个组成部分将探讨大量间歇性饮酒在急性心肌梗死（慢性和急性）发展中的作用，以及在急性心肌梗死患者预后中的作用。这些结果可能被证明具有重要的生物学，临床和公共卫生的CHD护理的影响。