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Alcohol consumption, coronary calcium, and coronary heart disease events
T Yang1, T M Doherty, N D Wong
1Department of Medicine, Harbor-UCLA Medical Center, Torrance, California 90502-2064, USA.
Insights
Moderate alcohol consumption may reduce coronary risk in high-risk individuals. This protective effect on coronary events is independent of traditional risk factors and coronary calcium levels.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- Coronary heart disease remains a leading cause of mortality worldwide.
- Identifying modifiable risk factors is crucial for prevention strategies.
- The role of alcohol consumption in cardiovascular health is complex and debated.
Purpose of the Study:
- To investigate the association between alcohol intake and coronary risk in a high-risk asymptomatic population.
- To determine if any observed protective effect of alcohol is independent of known coronary risk factors and coronary calcium.
- To compare the predictive value of alcohol consumption with established risk markers.
Main Methods:
- A cohort of 1,196 asymptomatic subjects with existing coronary risk factors was studied.
- Data collected included alcohol consumption history, traditional risk factor measurements, and coronary calcium quantification via electron beam computed tomography.
- Subjects were followed for a mean of 41 months to record coronary events (myocardial infarction or coronary death).
Main Results:
- Alcohol consumption and serum high-density lipoprotein cholesterol were significant inverse predictors of coronary events.
- Traditional risk factors (hypertension, smoking, diabetes, high cholesterol) and coronary calcium score were direct predictors.
- Individuals with coronary calcium were 3.1 times more likely to experience a coronary event.
- Alcohol drinkers had a significantly reduced relative risk (0.3, persisting at 0.58 after adjustment) for coronary events.
Conclusions:
- Alcohol consumption is a significant inverse predictor of coronary events in high-risk asymptomatic individuals.
- The cardioprotective effect of alcohol is comparable in magnitude to established risk factors and coronary calcium.
- This association persists even after controlling for conventional risk factors and coronary calcium, suggesting an independent protective role.
Abstract:
This study was performed to determine if alcohol intake was associated with reduced coronary risk in a high-risk asymptomatic population, and whether this effect was independent of coronary risk factors and coronary calcium. In 1,196 asymptomatic subjects with coronary risk factors, we assessed alcohol consumption history, performed risk factor measurements, and quantified coronary calcium with electron beam computed tomography. These subjects were then followed for a mean of 41 months, and coronary events (myocardial infarction or coronary death) were noted. Significant inverse predictors of coronary events included alcohol use and serum high-density lipoprotein cholesterol level. Direct predictors of events were history of systemic hypertension, smoking, diabetes mellitus, serum cholesterol, and coronary calcium score. Subjects with coronary calcium were 3.1 times more likely to suffer a coronary event than those without calcium (95% confidence interval [CI] limits 1.3 to 7.2). Subjects who drank alcohol had a relative risk of 0.3 (95% CI limits 0.2 to 0.6) for developing coronary events. After controlling for age, gender, and other risk factors with logistic regression, these differences in relative risk persisted (relative risk 0.58; 95% CI limits 0.41 to 0.82). Alcohol consumption is a significant inverse predictor of coronary events, comparable in magnitude to standard risk factors and to radiographically measured coronary calcium. This effect is independent of coronary risk factors and coronary calcium.