Drinking Patterns and Post MI Prognosis in Women

女性的饮酒模式和心肌梗死后的预后

基本信息

批准号：
7906831
负责人：
MURRAY A MITTLEMAN
金额：
$ 21.52万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-05 至 2012-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7906831
关键词：
Acute myocardial infarction Address Adult Alcohol consumption Alcoholic Beverages Behavioral Risk Factor Surveillance System Benefits and Risks Beverages Cardiovascular system Coronary heart disease Data Data Set Development Enrollment Epidemiology Ethanol Metabolism Exploratory/Developmental Grant Habits Heart Diseases Heavy Drinking Hospitalization Intake Life Mammography Medical center Myocardial Infarction NIH Program Announcements National Institute on Alcohol Abuse and Alcoholism Outcome Patients Pattern Predisposition Prevalence Recording of previous events Research Project Grants Risk Subgroup Surveys Sweden Telephone Testing Vulnerable Populations Woman acute coronary syndrome alcohol effect binge drinking cardiovascular risk factor cohort drinking drinking behavior high risk men mortality outcome forecast population based public health relevance response time use trend

项目摘要

DESCRIPTION (provided by applicant): Substantial epidemiological evidence indicates that alcohol consumed in moderation is associated with a lower risk of myocardial infarction (MI). Similar but less extensive evidence suggests that alcohol consumption is associated with better prognosis following MI, but this association has been tested virtually entirely among men. Even as the number of women with established coronary heart disease (CHD) continues to grow, almost no information is available to determine the possible risks and benefits of alcohol intake in this clinically vulnerable population. Exploration of the association between alcohol intake and prognosis among women with CHD is clearly needed. Men and women differ greatly in their drinking habits and beverage choices, metabolism of ethanol, susceptibility to many effects of alcohol, and their prognosis following MI, sharply limiting the generalizability of previous studies on men. In this application, we propose to explore the association of alcohol intake with long- term mortality among women enrolled in two complementary inception cohorts of adults hospitalized with CHD. These include the Determinants of Myocardial Infarction Onset Study, a multicenter cohort of patients hospitalized with confirmed acute MI at medical centers across the US, and the Swedish Mammography Cohort post-MI subgroup, a population-based cohort of women with a history of MI in central Sweden. In addition, we will describe the drinking patterns of U.S. women at higher cardiovascular risk, and their change over time, using the Behavioral Risk Factor Surveillance System, a population-based yearly telephone survey. Our primary hypothesis is: 1. Alcohol use up to 1 drink per day is inversely associated with total and cardiovascular mortality among women who survive hospitalization for both acute coronary syndromes and MI. Secondary exploratory aims include: 1. The association between alcohol consumption and total mortality is similar across alcoholic beverage types. 2. To describe the prevalence of alcohol use and heavy episodic drinking among women with coronary heart disease or cardiovascular risk factors. 3. To describe recent trends in alcohol use among women with coronary heart disease. PUBLIC HEALTH RELEVANCE: The number of women living with coronary heart disease is increasing, but almost no information is available to evaluate the possible risks and benefits of drinking alcohol in this vulnerable population. In this study we will evaluate the impact of drinking alcohol on the long-term prognosis of women who have survived heart attacks. We will also evaluate current trends in drinking behavior among women in the US who have coronary heart disease or are at high risk of developing it.

描述（由申请人提供）：大量流行病学证据表明，适量饮酒与降低心肌梗塞 (MI) 风险相关。类似但不太广泛的证据表明，饮酒与心肌梗死后更好的预后相关，但这种关联几乎完全在男性中进行了测试。尽管患有冠心病 (CHD) 的女性人数持续增加，但几乎没有任何信息可以确定这一临床弱势群体摄入酒精可能带来的风险和益处。显然需要探索患有先心病的女性的酒精摄入量与预后之间的关系。男性和女性在饮酒习惯和饮料选择、乙醇代谢、对酒精多种影响的易感性以及心肌梗死后的预后方面存在很大差异，这极大地限制了先前针对男性的研究的普遍性。在本申请中，我们建议探讨纳入两个补充性初始队列的患有先心病的成人患者中的女性的酒精摄入量与长期死亡率之间的关系。其中包括心肌梗死发作的决定因素研究（一个在美国各地医疗中心因确诊急性心肌梗死而住院的患者的多中心队列）和瑞典乳房 X 光检查队列后心肌梗死亚组（一个以人群为基础的队列，其中有心肌梗死史的女性）瑞典中部。此外，我们将使用行为风险因素监测系统（一项基于人群的年度电话调查）来描述心血管风险较高的美国女性的饮酒模式及其随时间的变化。我们的主要假设是： 1. 对于因急性冠脉综合征和心肌梗死住院的女性，每天饮酒最多 1 杯与总死亡率和心血管死亡率呈负相关。次要探索目标包括： 1. 不同酒精饮料类型的饮酒量与总死亡率之间的关联相似。 2. 描述患有冠心病或心血管危险因素的女性中饮酒和偶尔大量饮酒的流行情况。 3. 描述患有冠心病的女性饮酒的最新趋势。公共卫生相关性：患有冠心病的女性人数正在增加，但几乎没有信息可以评估这一弱势群体饮酒可能带来的风险和益处。在这项研究中，我们将评估饮酒对心脏病幸存者的长期预后的影响。我们还将评估美国患有冠心病或患冠心病高风险女性当前饮酒行为的趋势。