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，适度饮酒与较低的心肌梗死(MI)风险相关。类似但不太广泛的证据表明，饮酒与心肌梗塞后更好的预后有关，但这种相关性几乎完全在男性中进行了测试。尽管患有冠心病(CHD)的女性人数持续增长，但几乎没有任何信息可以确定饮酒在这一临床脆弱人群中可能存在的风险和好处。显然，有必要探讨女性冠心病患者饮酒与预后之间的关系。男性和女性在饮酒习惯和饮料选择、乙醇的新陈代谢、对酒精的许多影响的敏感性以及心肌梗塞后的预后方面存在很大差异，这极大地限制了以前对男性的研究的概括性。在这项应用中，我们建议在两个相辅相成的成年冠心病住院患者队列中，探索酒精摄入量与长期死亡率的关系。这些研究包括心肌梗塞发病的决定因素研究，这是美国各地医疗中心确诊为急性心肌梗塞而住院的多中心队列患者，以及瑞典乳房摄影术后心肌梗塞亚组，这是瑞典中部有心肌梗塞病史的以人群为基础的队列女性。此外，我们将使用行为风险因素监测系统描述心血管风险较高的美国女性的饮酒模式，以及她们随时间的变化。行为风险因素监测系统是一项基于人群的年度电话调查。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女性中，每天饮酒不超过1杯与总死亡率和心血管死亡率呈负相关。第二个研究目标包括：1.在不同类型的酒精饮料中，饮酒和总死亡率之间的关联是相似的。2.描述有冠心病或心血管危险因素的女性中饮酒和大量饮酒的患病率。3.描述冠心病女性饮酒的最新趋势。 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以评估饮酒在这一脆弱人群中可能的风险和好处。在这项研究中，我们将评估饮酒对心脏病发作幸存者的长期预后的影响。我们还将评估美国患有冠心病或有高风险患冠心病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.