scholarly journals The impact of frequency, pattern, intensity, and type of alcohol consumption, and its combined effect with smoking on inflammation, lipid profile, and the risk of myocardial infarction

2019 ◽  
Author(s):  
Ritienne Attard ◽  
Philip Dingli ◽  
Carine J. M. Doggen ◽  
Karen Cassar ◽  
Rosienne Farrugia ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Alcohol Consumption ◽  
Lipid Profile ◽  
Smoking Status ◽  
Alcoholic Beverage ◽  
Combined Effect ◽  
Pattern Frequency ◽  
Increased Risk ◽  
Hs Crp ◽  
The Impact

Abstract Aim To determine the risk of myocardial infarction (MI) associated with pattern, frequency, and intensity of alcohol consumption, type of alcoholic beverage, and the combined effect of alcohol and smoking on risk of MI, inflammation, and lipid profile. Method A total of 423 cases with a first MI and 465 controls from the Maltese Acute Myocardial Infarction (MAMI) Study were analysed. Data was collected through an extensive interviewer-led questionnaire, along with measurements of various blood parameters. Medians and the Mann–Whitney test were used to assess effect of different drinking patterns, frequency, intensity, and smoking and drinking combinations on hs-CRP and lipid profile. Odds ratios, adjusted for the conventional risk factors of MI (AdjORs), were calculated as an estimate of the relative risk of MI. Results Regular alcohol consumption protected against MI [AdjOR 0.6 (95% CI 0.4–0.9)] while daily binge drinking increased risk [AdjOR 5.0 (95% CI 1.6–15.0)] relative to regular drinkers who did not binge drink. Whereas moderate weekly consumption of wine protected against MI, high weekly consumption of beer conveyed a deleterious effect. Alcohol consumption decreased risk of MI independent of smoking status. Frequent alcohol consumption was associated with higher HDL-, non-HDL-, total cholesterol and triglycerides, and lower hs-CRP. Total and HDL-cholesterol increased and BMI decreased with increasing quantity of weekly alcohol consumption relative to the non-regular drinkers. The effect of smoking on lipid profile and hs-CRP was less pronounced in current drinkers than in those who were non-regular drinkers. Conclusion The protective effect of alcohol consumption was dependent on the pattern, frequency, type, and intensity of alcohol consumed. Alcohol modified the effects of smoking on the lipid profile. Regular drinking attenuated the effect of smoking on hs-CRP and lipid profile.

scholarly journals The association of smoking to cardiovascular death differs according to age and sex following myocardial infarction complicated by heart failure or left ventricular dysfunction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.S Hall ◽  
S Orn ◽  
F Zannad ◽  
P Rossignol ◽  
K Duarte ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Smoking Status ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Increased Risk ◽  
The Impact ◽  
Age And Sex

Abstract Background Smoking is associated with higher morbidity and mortality following myocardial infarction (MI), but reports of the impact on cardiovascular (CV) death in aged and female patients experiencing MI complicated with left ventricular dysfunction or overt heart failure are limited. Methods In an individual patient data meta-analysis of high-risk MI patients, the association of smoking to CV death was investigated. Cox proportional hazard models exploring smoking status and risk according to age and sex were performed to study the relationship of smoking to independently adjudicated CV death endpoints. Results 28,771 patients from the CAPRICORN, EPHESUS, OPTIMAAL and VALIANT trials were assessed. 18,325 (64%) reported smoking (9185 (32%) current and 9051 (32%) past), 2662 (9%) were above ≥80 years and 8607 (30%) were women. Overall, using non-smokers as referent, the association of smoking to CV mortality was neutral (HR=1.07, 0.98 to 1.16, p=0.12 for active smoking and HR=1.10, 1.02 to 1.18, p=0.01 for past smoking). The associations for active and past smokers with outcome, adjusted for age and sex in the overall study sample and according to different age and sex categories, are presented in figure 1. In analyses that included interaction terms, the association for active smokers depended on age and sex; the risk of CV mortality was weakened in women (interaction HR=0.81, 0.69 to 0.96, p=0.01) and older age (interaction HR per 10 years increase=0.88, 0,82 to 0.95, p=0.001). In contrast, the association to CV death for past smokers was not modified by sex or age (p=0.86 and p=0.17 respectively). Conclusions The association of smoking to CV death differed according to age and sex in MI complicated with left ventricular dysfunction or overt heart failure. Significant association of active and/or past smoking with increased risk of CV death was mainly observed in the 60–69 years category. The underlying reasons of the lack of association of smoking with outcome in older patients in this specific context should be explored further in future studies. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Obesity is positively related and tobacco smoking and alcohol consumption are negatively related to an increased risk of thyroid cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Soo-Youn An ◽  
So Young Kim ◽  
Dong Jun Oh ◽  
Chanyang Min ◽  
Songyoung Sim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Alcohol Consumption ◽  
Smoking Status ◽  
Conditional Logistic Regression ◽  
Overweight And Obesity ◽  
Control Group ◽  
Increased Risk ◽  
Region Of Residence ◽  
Korean National Health Insurance ◽  
Comorbidity Index

Abstract The purpose of this study was to evaluate the relationships of smoking, alcohol consumption, and obesity with thyroid cancer in Korean residents. The Korean National Health Insurance Service-Health Screening Cohort includes individuals ≥ 40 years who were assessed from 2002 to 2013. In total, 4977 thyroid cancer participants were matched with respect to age, sex, income, and region of residence with 19,908 controls at a ratio of 1:4. Crude and adjusted (for the Charlson comorbidity index, smoking status, frequency of alcohol consumption, and obesity) odds ratios (ORs) were analyzed using conditional logistic regression analyses. Additionally, 95% confidence intervals (CIs) were calculated. The adjusted OR of smoking for thyroid cancer was 0.62 (95% CI 0.54–0.72, P < 0.001), and that of alcohol consumption was 0.83 (95% CI 0.75–0.92, P < 0.001). The adjusted ORs of the BMI categories were 1.13 (95% CI 1.05–1.22, P = 0.002) for obese I, and 1.24 (95% CI 1.04–1.47, P = 0.014) for obese II. The ORs of smoking and alcohol consumption were lower, and those of overweight and obesity were higher in thyroid cancer patients than in individuals in the control group.

scholarly journals Impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular infarction

2006 ◽  
Vol 124 (4) ◽  
pp. 186-191 ◽  
Author(s):  
Afonso Celso Pereira ◽  
Roberto Alexandre Franken ◽  
Sandra Regina Schwarzwälder Sprovieri ◽  
Valdir Golin
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Right Ventricular ◽  
Left Ventricular ◽  
Hospital Death ◽  
Inferior Wall ◽  
Mortality And Morbidity ◽  
Killip Class ◽  
Increased Risk ◽  
The Impact

CONTEXT AND OBJECTIVE: There is uncertainty regarding the risk of major complications in patients with left ventricular (LV) infarction complicated by right ventricular (RV) involvement. The aim of this study was to evaluate the impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular myocardial infarction. DESIGN AND SETTING: Prospective cohort study, at Emergency Care Unit of Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo. METHODS: 183 patients with acute myocardial infarction participated in this study: 145 with LV infarction alone and 38 with both LV and RV infarction. The presence of complications and hospital death were compared between groups. RESULTS: 21% of the patients studied had LV + RV infarction. In this group, involvement of the dorsal and/or inferior wall was predominant on electrocardiogram (p < 0.0001). The frequencies of Killip class IV upon admission and 24 hours later were greater in the LV + RV group, along with electrical and hemodynamic complications, among others, and death. The probability of complications among the LV + RV patients was 9.7 times greater (odds ratio, OR = 9.7468; 95% confidence interval, CI: 2.8673 to 33.1325; p < 0.0001) and probability of death was 5.1 times greater (OR = 5.13; 95% CI: 2.2795 to 11.5510; p = 0.0001), in relation to patients with LV infarction alone. CONCLUSIONS: Patients with LV infarction with RV involvement present increased risk of early morbidity and mortality.

scholarly journals Association Between Smoking Status and Outcomes in ST-Segment Elevation and Non-ST-Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Ching-Hui Sia ◽  
Junsuk Ko ◽  
Huili Zheng ◽  
Andrew Ho ◽  
David Foo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Smoking Status ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Beneficial Effects ◽  
St Segment ◽  
Increased Risk ◽  
Percutaneous Coronary

Abstract Smoking is one of the leading risk factors for cardiovascular diseases, including ischemic heart disease and hypertension. However, in acute myocardial infarction (AMI) patients, smoking has been associated with better clinical outcomes, a phenomenon termed the “smoker’s paradox.” Given the known detrimental effects of smoking on the cardiovascular system, it has been proposed that the beneficial effects of smoking on outcomes is due to age differences between smokers and non-smokers and is therefore a smoker’s pseudoparadox. The aim of this study was to evaluate the association between smoking status and clinical outcomes in ST-segment elevation (STEMI) and non-STEMI (NSTEMI) patients treated by percutaneous coronary intervention (PCI), using a national multi-ethnic Asian registry. In unadjusted analyses, current smokers had better clinical outcomes following STEMI and NSTEMI. However, after adjusting for age, the protective effect of smoking was lost, confirming a smoker’s pseudoparadox. Interestingly, although current smokers had increased risk for recurrent MI within 1 year after PCI in both STEMI and NSTEMI patients, there was no increase in mortality. In summary, we confirm the existence of a smoker’s pseudoparadox in a multi-ethnic Asian cohort of STEMI and NSTEMI patients and report increased risk of recurrent MI, but not mortality, in smokers.

scholarly journals Culprit vessel: impact on short-term and long-term prognosis in patients with ST-elevation myocardial infarction

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000852 ◽  
Author(s):  
Artin Entezarjou ◽  
Moman Aladdin Mohammad ◽  
Pontus Andell ◽  
Sasha Koul
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
High Risk ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Clinical Event ◽  
Left Ventricular Ejection ◽  
Increased Risk ◽  
St Elevation ◽  
The Impact

BackgroundST-elevation myocardial infarction (STEMI) occurs as a result of rupture of an atherosclerotic plaque in the coronary arteries. Limited data exist regarding the impact of culprit coronary vessel on hard clinical event rates. This study investigated the impact of culprit vessel on outcomes after primary percutaneous coronary intervention (PCI) of STEMI.MethodsA total of 29 832 previously cardiac healthy patients who underwent primary PCI between 2003 and 2014 were prospectively included from the Swedish Coronary Angiography and Angioplasty Registry and the Registry of Information and Knowledge about Swedish Heart Intensive care Admissions. Patients were stratified into three groups based on culprit vessel (right coronary artery (RCA), left anterior descending artery (LAD) and left circumflex artery (LCx)). The primary outcome was 1-year mortality. The secondary outcomes included 30-day and 5-year mortality, as well as heart failure, stroke, bleeding and myocardial reinfarction at 30 days, 1 year and 5 years. Univariable and multivariable analyses were done using Cox regression models.ResultsOne-year analyses revealed that LAD infarctions had the highest increased risk of death, heart failure and stroke compared with RCA infarctions, which had the lowest risk. Sensitivity analyses revealed that reduced left ventricular ejection fraction on discharge partially explained this increased relative risk in mortality. Furthermore, landmark analyses revealed that culprit vessel had no significant influence on 1-year mortality if a patient survived 30 days after myocardial infarction. Subgroup analyses revealed female sex and multivessel disease (MVD) as significant high-risk groups with respect to 1-year mortality.ConclusionsLAD and LCx infarctions had a relatively higher adjusted mortality rate compared with RCA infarctions, with LAD infarctions in particular being associated with an increased risk of heart failure, stroke and death. Culprit vessel had limited influence on mortality after 1 month. High-risk patient groups include LAD infarctions in women or with concomitant MVD.

Abstract 3586: Alcohol Consumption and One-Year Angina Risk After Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Donna M Buchanan ◽  
Surya Mundluru ◽  
James H O’Keefe ◽  
Kimberly J Reid ◽  
Fengmeng Tang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Cardiovascular Risks ◽  
Dependent Relationship ◽  
Increased Risk ◽  
Heavy Alcohol Consumption ◽  
Acute Mi ◽  
Excessive Alcohol ◽  
One Year

Background: Prior studies show light to moderate alcohol use is associated with reduced mortality and cardiovascular events, whereas heavy use increases mortality and cardiovascular risks. The association of alcohol use and post-myocardial infarction (MI) symptoms is unknown. We explored the association between alcohol use and risk of having angina 1 year after an MI. Methods: Upon enrollment in the 19-center prospective PREMIER registry, acute MI patients (n=2481) were asked about alcohol use. Angina (any vs. none) was assessed at 1 year with the Seattle Angina Questionnaire. The association of alcohol use and 1-year angina was modeled using a hierarchical multivariable modified Poisson regression model. Results: Overall, 47% reported never drinking and others reported having the following # of drinks/day: 42% < 1; 6% 1 to 2; 3% > 2 to 4; 2% > 4. After adjusting for demographic, clinical, and treatment variables, patients that reported never drinking were 45% more likely to have angina than moderate drinkers (1 to 2 drinks/day). However, > drinks/day was associated with an 81% greater risk of angina than moderate alcohol use. Those drinking < 1 drink/day or > 2 to 4 per day had similar angina risk compared to moderate drinkers. Results did not vary by gender (p > .05 for interaction). Conclusions: This study extends prior evidence of a dose-dependent relationship between alcohol use and other cardiovascular benefits/risks to post-MI angina. Moderate alcohol consumption (1 to 2 drinks/day) was associated with reduced risk of angina 1 year after MI compared to abstinence or heavy alcohol consumption. Excessive alcohol use (>4 drinks/day) was associated with increased risk of angina.

Abstract P260: Can Metabolic Syndrome Predict the Incidence of Silent Myocardial Infarction? An Analysis From the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yong Shen ◽  
Stephanie Filipp ◽  
Matthew J Gurka ◽  
Mark D DeBoer ◽  
Thomas A Pearson
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Severity Score ◽  
Smoking Status ◽  
Heart Diseases ◽  
Significant Risk ◽  
Predictive Tool ◽  
Aric Study ◽  
The Impact ◽  
Silent Myocardial Infarction

Introduction: Diabetes patients are at risk for clinical Myocardial Infarction (MI) and have a larger proportion being silent Myocardial Infarction. However, less is known about the impact of Metabolic Syndrome (MetS, also known as prediabetes) on the incidence of silent MI. Here, we studied whether the degree of MetS severity can be predictive for future risk of silent MI. Methods: 12,527 ARIC study participants who are free of coronary heart diseases (CHD) and diabetes at baseline (1987-1989) were included for the analysis. Silent MI was determined by ECG serial changes of MI without prior clinical history of MI. A continuous MetS severity score was formulated from the integration of MetS components to assess its prediction for future silent MI and clinical MI. Results and Conclusions: 458 participants (3.7%, 458 of 12,527) developed clinical MI and 87 (0.7%, 87 of 12,527) were diagnosed with silent MI until ARIC visit 4 (1996-1998). Within the 10 years follow-up period, gender, smoking status, MetS components (waist circumference, blood pressure, HDL cholesterol) and the integrated MetS severity score were identified as significant risk factors for the incidence of both silent MI and clinical MI. Participants with MetS had a significant adjusted HR for incident silent MI (HR = 1.98, 95% CI: [1.30, 3.02], p=0.0015) as compared to clinical MI (HR = 1.67, 95% CI: [1.39, 2.00], p<0.0001). The 10-year risk scoring equations of silent MI and clinical MI were constructed as a multivariate predictive tool based on MetS severity score. In conclusion, higher MetS severity score is associated with further risk of both clinical and silent MI, identifying the potential clinical application of MetS severity score in MI prevention.

scholarly journals Adolescent wine consumption is inversely associated with long-term weight gain: results from follow-up of 20 or 22 years

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Pratiksha Poudel ◽  
Kamila Ismailova ◽  
Lars Bo Andersen ◽  
Sofus C. Larsen ◽  
Berit L. Heitmann
Keyword(s):  
Weight Gain ◽  
Alcohol Consumption ◽  
Smoking Status ◽  
Alcoholic Beverage ◽  
Activity Levels ◽  
Inverse Association ◽  
Wine Consumption ◽  
The Relationship

Abstract Background Several studies have suggested a link between the type of alcoholic beverage consumption and body weight. However, results from longitudinal studies have been inconsistent, and the association between adolescent alcohol consumption long-term weight gain has generally not been examined. Methods The study was based on data from 720 Danish adolescents aged between 15 to 19 years at baseline from the Danish Youth and Sports Study (YSS). Self-reported alcohol use, height, weight, smoking, social economic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985, and in the follow up survey which was conducted in 2005. Multiple linear regression analyses were used to examine the association between alcohol consumption in adolescence and subsequent weight gain later in midlife. Results There was no significant association between total alcohol consumption during adolescence and change in BMI into midlife (P = 0.079) (β − 0.14; 95% CI -0.28, 0.005). Wine consumption was found to be inversely associated to subsequent BMI gain (P = 0.001) (β − 0.46; 95% CI -0.82, − 0.09) while the results were not significant for beer and spirit. The relationship did not differ by gender, but smoking status was found to modify the relationship, and the inverse association between alcohol and BMI gain was seen only among non-smokers (P = 0.01) (β − 0.24; 95% CI -0.41, − 0.06) while no association was found among smokers. Neither adolescent nor attained socioeconomic status in adulthood modified the relationship between alcohol intake and subsequent BMI gain. Conclusion Among non-smoking adolescents, consumption of alcohol, and in particular wine, seems to be associated with less weight gain until midlife. Trial registration The YSS cohort was retrospectively registered on August 2017. (Study ID number: NCT03244150).

Myocardial reperfusion reverses the J-curve association of cardiovascular risk and diastolic blood pressure in patients with left ventricular dysfunction and heart failure after myocardial infarction: insights from the EPHESUS trial

2020 ◽  
Vol 41 (17) ◽  
pp. 1673-1683 ◽  
Author(s):  
Michael Böhm ◽  
João Pedro Ferreira ◽  
Felix Mahfoud ◽  
Kevin Duarte ◽  
Bertram Pitt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cox Regression ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
Coronary Perfusion ◽  
Increased Risk ◽  
The Impact

Abstract Aims The described association of low diastolic blood pressure (DBP) with increased cardiovascular outcomes could be due to reduced coronary perfusion or is simply due to reverse causation. If DBP is physiologically relevant, coronary reperfusion after myocardial infarction (MI) might influence DBP–risk association. Methods and results The relation of achieved DBP with cardiovascular death or cardiovascular hospitalization, cardiovascular death, and all-cause death was explored in 5929 patients after acute myocardial infarction (AMI) with impaired left ventricular function, signs and symptoms of heart failure, or diabetes in the EPHESUS trial according to their reperfusion status. Cox regression models were used to assess the impact of reperfusion status on the association of DBP and systolic blood pressure (SBP) with outcomes in an adjusted fashion. In patients without reperfusion, lower DBP &lt;70 mmHg was associated with increased risk for all-cause death [adjusted hazard ratios (HRs) 1.80, 95% confidence interval (CI) 1.41–2.30; P &lt; 0.001], cardiovascular death (HR 1.70, 95% CI 1.3–3.22; P &lt; 0.001), cardiovascular death or cardiovascular hospitalization (HR 1.54, 95% CI 1.26–1.87; P &lt; 0.001). In patients with reperfusion, the risk increase at low DBP was not observed. At low SBP, risk increased independently of reperfusion. A sensitivity analysis in the subgroup of patients with optimal SBP of 120–130 mmHg showed again risk reduction of reperfusion at low DBP. Adding the treatment allocation to eplerenone or placebo into the models had no effects on the results. Conclusion Patients after AMIs with a low DBP had an increased risk, which was sensitive to reperfusion therapy. Low blood pressure after MI identifies in patients with particular higher risk. These data support the hypothesis that low DBP in patients with stenotic coronary lesions is associated with risk, potentially involving coronary perfusion pressure and the recommendations provided by guidelines suggesting lower DBP boundaries for these high-risk patients.

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