Drinking Patterns and Post MI Prognosis in Women

描述（由申请人提供）：大量流行病学证据表明，适量饮酒与心肌梗死（MI）风险降低相关。类似但不太广泛的证据表明，饮酒与MI后更好的预后相关，但这种关联几乎完全在男性中进行了测试。尽管确诊冠心病（CHD）的女性人数持续增长，但几乎没有任何信息可以确定酒精摄入在这一临床弱势人群中可能的风险和益处。对女性冠心病患者酒精摄入量与预后之间的关系的探讨显然是必要的。男性和女性在饮酒习惯和饮料选择、乙醇代谢、对酒精多种影响的敏感性以及MI后的预后方面存在很大差异，这大大限制了以往对男性研究的普遍性。在这项应用中，我们建议探讨酒精摄入与冠心病住院成人的两个互补的初始队列中的女性长期死亡率之间的关系。这些研究包括心肌梗死发作的决定因素研究，一项在美国各地医疗中心因确诊急性MI住院的多中心患者队列，以及瑞典乳腺X线摄影队列MI后亚组，一项在瑞典中部有MI病史的女性人群队列。此外，我们将描述美国女性的饮酒模式在较高的心血管风险，他们随着时间的推移变化，使用行为风险因素监测系统，一个以人口为基础的年度电话调查。我们的主要假设是：1。在因急性冠脉综合征和心肌梗死而住院的妇女中，每天饮酒1次与总死亡率和心血管死亡率呈负相关。次要的探索目标包括：1。酒精消费与总死亡率之间的关联在酒精饮料类型中是相似的。 2.描述有冠心病或心血管危险因素的女性中饮酒和重度间歇性饮酒的患病率。3.描述女性冠心病患者饮酒的近期趋势。 公共卫生相关性：患有冠心病的妇女人数正在增加，但几乎没有任何信息可用于评估饮酒对这一弱势群体的可能风险和益处。在这项研究中，我们将评估饮酒对心脏病发作幸存妇女的长期预后的影响。我们还将评估美国患有冠心病或有高风险的女性饮酒行为的当前趋势。

DESCRIPTION (provided by applicant): Substantial epidemiological evidence indicates that alcohol consumed in moderation is associated with a lower risk of myocardial infarction (MI). Similar but less extensive evidence suggests that alcohol consumption is associated with better prognosis following MI, but this association has been tested virtually entirely among men. Even as the number of women with established coronary heart disease (CHD) continues to grow, almost no information is available to determine the possible risks and benefits of alcohol intake in this clinically vulnerable population. Exploration of the association between alcohol intake and prognosis among women with CHD is clearly needed. Men and women differ greatly in their drinking habits and beverage choices, metabolism of ethanol, susceptibility to many effects of alcohol, and their prognosis following MI, sharply limiting the generalizability of previous studies on men. In this application, we propose to explore the association of alcohol intake with long- term mortality among women enrolled in two complementary inception cohorts of adults hospitalized with CHD. These include the Determinants of Myocardial Infarction Onset Study, a multicenter cohort of patients hospitalized with confirmed acute MI at medical centers across the US, and the Swedish Mammography Cohort post-MI subgroup, a population-based cohort of women with a history of MI in central Sweden. In addition, we will describe the drinking patterns of U.S. women at higher cardiovascular risk, and their change over time, using the Behavioral Risk Factor Surveillance System, a population-based yearly telephone survey. Our primary hypothesis is: 1. Alcohol use up to 1 drink per day is inversely associated with total and cardiovascular mortality among women who survive hospitalization for both acute coronary syndromes and MI. Secondary exploratory aims include: 1. The association between alcohol consumption and total mortality is similar across alcoholic beverage types. 2. To describe the prevalence of alcohol use and heavy episodic drinking among women with coronary heart disease or cardiovascular risk factors. 3. To describe recent trends in alcohol use among women with coronary heart disease. PUBLIC HEALTH RELEVANCE: The number of women living with coronary heart disease is increasing, but almost no information is available to evaluate the possible risks and benefits of drinking alcohol in this vulnerable population. In this study we will evaluate the impact of drinking alcohol on the long-term prognosis of women who have survived heart attacks. We will also evaluate current trends in drinking behavior among women in the US who have coronary heart disease or are at high risk of developing it.