Lack of effect of recent alcohol consumption on the course of acute myocardial infarction.
OBJECTIVE
Alcohol has marked effects on hemodynamic and hemostatic variables that might alter the presentation of acute myocardial infarction that follows its use. We sought to determine whether recent alcohol consumption alters the course or complications of acute myocardial infarction.


METHODS
In the Determinants of Myocardial Infarction Onset Study, we performed chart reviews and face-to-face interviews with 2161 patients who did not receive thrombolytic therapy. We assessed alcohol use before infarction, peak creatine kinase levels (1043 patients), electrocardiographic interpretations (1408 patients), and the presence of ventricular arrhythmias or congestive heart failure (all patients).


RESULTS
Among the 2161 patients, 399 (18.5%) drank alcohol within 24 hours before myocardial infarction. We found no significant difference in mean peak creatine kinase level between those who had recently used alcohol and those who had not in an adjusted comparison (-6.1% difference; 95% confidence interval [CI] -20.3%-10.7%; P =.46). We also found no differences in adjusted risk for Q-wave infarction, congestive heart failure, or ventricular arrhythmias (odds ratios 1.03 [95% CI, 0.73-1.45; P =.88], 1.01 [95% CI, 0.67-1.54; P =.95], and 1.04 [95% CI, 0.66-1.65; P =.86]). Categorization of the duration since last alcohol use into 6-hour intervals revealed no trends between time since last use of alcohol and any of these outcomes.


CONCLUSIONS
Recent alcohol use is not associated with changes in infarct size or risk for Q-wave infarction, congestive heart failure, or ventricular arrhythmia among this population.
Mukamal
K J
KJ
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. kmukamal@caregroup.harvard.edu
Muller
J E
JE
Maclure
M
M
Sherwood
J B
JB
Mittleman
M A
MA
D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017180:Tachycardia, Ventricular / Q000097:blood / Q000209:etiology / Q000503:physiopathology
D003402:Creatine Kinase