Estudios científicos
Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: The Second Manifestations of ARTerial (SMART) disease study
Abstract:
OBJECTIVE: This study investigated the relation between alcohol consumption and specific vascular events and mortality in a high risk population of patients with clinical manifestations of vascular disease and diabetes. METHODS: Patients with clinically manifest vascular disease or diabetes (n=5447) from the SMART study were followed for cardiovascular events and mortality. Alcohol consumption was assessed with a baseline questionnaire and analysed in relation with coronary heart disease (CHD), amputations, stroke, and all-cause and vascular death. RESULTS: After a follow up of 4.7 years, we documented 363 cases of CHD, 187 cases of stroke, 79 amputations and 641 cases of all-cause death, of which 382 were vascular. In multivariate-adjusted models, alcohol consumption was inversely associated with CHD (p(linear trend)=0.007) and stroke (p(linear trend)=0.051) with respective hazard ratios of 0.39 (95%CI: 0.20-0.76) and 0.67 (0.31-1.46) for consuming 10-20 drinks/week compared with abstainers. We observed significant U-shaped associations between alcohol consumption and amputations (p(quadratic trend)=0.001), all-cause death (p(quadratic trend)=0.001) and vascular death (p(quadratic trend)=0.013). Hazard ratios for consuming 10-20 drinks/week were 0.29 (0.07-1.30) for amputations, 0.40 (0.24-0.69) for all-cause death and 0.34 (0.16-0.71) for vascular death compared with abstainers. Similar associations were observed for red wine consumption only. CONCLUSION: Moderate alcohol consumption (1-2 drinks/day) is not only associated with a reduced risk of vascular and all-cause death in a high risk patients with clinical manifestations of vascular disease, but also with reduced risks of non-fatal events like CHD, stroke and possibly amputations. Copyright © 2010. Published by Elsevier Ireland Ltd.
Comentarios divulgativos:
Este estudio investiga la relación entre el consumo de alcohol y determinados eventos vasculares así como mortalidad en una población de alto riesgo de pacientes con manifestaciones clínicas de enfermedades vasculares y diabetes. Los pacientes con enfermedad vascular o diabetes fueron seguidos según los criterios de padecer eventos cardiovasculares y mortalidad. El consumo de alcohol se evaluó mediante un cuestionario inicial y se analizó en relación a padecer enfermedad cardiaca coronaria (CHD), amputaciones, derrame cerebral, y muerte por todas las causas. Después de un seguimiento de 4,7 años se documentaron 363 casos de cardiopatía coronaria, 187 casos de ictus, 79 de amputaciones y 641 casos de muerte por cualquier causa de los cuales 382 fueron vasculares. En los modelos multivariantes ajustados el consumo de alcohol se asoció inversamente con la enfermedad coronaria. Se observó una importante asociación en forma de U entre el consumo de alcohol y las amputaciones. El consumo moderado de alcohol (1-2 copas al día) no solo se asocia con un menor riesgo de padecer enfermedades vasculares y muerte por cualquier causa en pacientes de alto riesgo sino también con menores riesgos de eventos no mortales como padecer enfermedades del corazón, derrame cerebral y amputaciones.