以前のアルコール摂取と急性心筋梗塞後の死亡率
K J Mukamal1, M Maclure, J E Muller
1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY-303, Boston, MA 02215, USA. kmukamal@caregroup.harvard.edu
JAMA
|April 20, 2001
まとめ
急性心筋梗塞 (AMI) 前での適度なアルコール摂取は,長期的な死亡率の低下と関連しています. この研究では,週7杯以上のアルコール飲料を飲む人は,禁酒者と比較して,AMI後の死亡率を低下させたことが判明しました.
科学分野:
- 心臓病学 心臓病学
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 以前の研究では,適度なアルコール摂取が第1次急性心筋梗塞 (AMI) のリスクを低下させる可能性があることが示唆されています.
- AMI以前のアルコールの摂取が生存者の死亡率に与える影響は不明である.
研究 の 目的:
- 前回のアルコール摂取と,AMIを生き延びた患者の長期的な死亡率との関連性を調査する.
- AMIの前の1年間の自己報告された週間のアルコール摂取量 (ビール,ワイン,アルコール) に基づいて死亡率を分析する.
主な方法:
- 米国45の病院 (1989-1994) で1913人の成人AMI生存者を対象とした前向きの初期コホート研究.
- 追跡期間の中央値は3.8年でした.
- すべての原因による死亡率の評価は,自己報告されたアルコール摂取量 (禁酒者,週7杯以下,週7杯以上) と関連しています.
主要な成果:
- 週7杯未満の飲料を摂取した患者は,禁酒者よりも45%低い死亡率を示した (HR 0.55).
- 週に7杯以上飲む人は,禁酒者よりも62%低い死亡率 (HR 0.38) を有していた.
- 混同因子調整後,適度なアルコール摂取量 (<7杯/週および≥7杯/週) は,依然として死亡率の有意な減少と関連していました (調整されたHRはそれぞれ0.79および0.68).
結論:
- AMIの前の1年間に自己報告された適度なアルコール摂取は,長期的な死亡率の低下と関連しています.
- この発見は,心筋梗塞後の生存に適度な飲酒の潜在的な保護効果を示しています.
- この関連性は,異なる飲料タイプ,性別,および総死亡率と心血管疾患による死亡率の両方において一貫していました.
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