A Retrospective Study Examining Self-Reported Alcohol Intake Among Adult Patients With Myocardial Infarction

Alcohol intake has long been linked to cardiovascular risk, but prior evidence is inconsistent. While chronic heavy use is associated with increased risk of myocardial infarction (MI) and coronary heart disease (CHD), some studies suggest protective effects of moderate consumption. The impact of binge drinking, a distinct and common drinking pattern, on MI and CHD remains less clearly defined. Understanding this association is important for refining prevention and public health strategies.

This study aims to evaluate the association between self-reported binge drinking (as defined by the CDC (Centers for Disease Control and Prevention) criteria) and the prevalence of MI or CHD in adults, and to assess whether this association varies across demographic and socioeconomic subgroups using the 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset.

This retrospective study utilized the BRFSS database. The disease variable was self-reported MI, and the risk factor was binge drinking (yes/no). Control variables included age, gender, race, and socioeconomic factors (education and income). Data were analyzed using cross-tabulations and tests, with results expressed as odds ratios (ORs) and 95% confidence intervals (CIs).

Out of 56,539 binge drinkers, 2,570 (4.5%) had MI, and out of 333,406 non-binge drinkers, 300,336 (90.1%) did not have MI. The odds ratio of 0.432 indicates that participants who reported being binge drinkers were 56.8% less likely to have MI when compared to non-binge drinkers. MI was more prevalent in males, with 1,942 of 34,272 binge drinkers (5.7%), compared with 628 of 22,267 binge drinkers (2.8%) in females. About 4.6% of 41,547 White binge drinkers had MI, 4.9% of 3,253 Black binge drinkers had MI, and 3.5% of 6,331 Hispanic binge drinkers had MI. The likelihood of association between MI or CHD and binge drinking was 46.9% higher (OR=1.469) in those aged 18-24 years, 24.3% lower (OR=0.757) in those aged 25-44 years, 27.6% lower (OR=0.724) in those aged 45-64 years, and 18.8% lower (OR=0.812) in those aged 65 years and older. The likelihood of association between MI or CHD and binge drinking was 58.5% lower (OR=0.415) in males, and 65.3% lower (OR=0.347) in females. The likelihood of association between MI or CHD and binge drinking was 59.5% lower (OR=0.405) in White participants, 42.9% lower (OR=0.571) in Black participants, and 45.5% lower (OR=0.545) in Hispanic participants. Prevalence of MI or CHD in binge drinkers was 983 (6.1%) among participants with basic education out of a total of 16,023 and 1,578 (3.9%) among participants with advanced education out of a total of 40,373. The likelihood of association of MI or CHD in binge drinkers was 52.5% lower (OR=0.475) in participants with basic education, and 58.9% lower (OR=0.411) in participants with advanced education. The likelihood of association of MI or CHD in binge drinkers was 48.5% lower (OR=0.515) in participants with income <$50,000, and 56.9% lower (OR=0.431) in participants with income >$50,000.

In this cross-sectional analysis of the 2022 BRFSS dataset, binge drinking was associated with lower reported prevalence of MI/CHD. These findings should be interpreted cautiously, given the self-reported data, potential confounding, and inability to infer causality.