title: Effects of alcoholism on coronary artery disease and left ventricular dysfunction in male veterans.
abstract: BACKGROUND
  Heavy alcohol consumption is a well-known cause of dilated cardiomyopathy and hypertension, but its effects on coronary atherosclerosis are less well understood. The objective of this study was to compare coronary anatomy and left ventricular dysfunction in patients with and without alcoholism associated with heavy consumption.
  
  
  METHODS
  We studied 100 consecutive alcoholic male patients presenting with chest pain to the Department of Veterans Affairs New York Harbor Healthcare System (VA) between 1994 and 2002. Alcoholism was defined as a history of either chronic alcohol-related pancreatitis or liver cirrhosis. Patients were compared to age-matched controls (n = 200) that were known to be nonalcoholic. All patients underwent coronary angiography.
  
  
  RESULTS
  Baseline demographic characteristics were similar between the two groups. The prevalence of significant coronary artery disease (CAD) (defined as coronary arterial luminal diameter stenosis > 50%) was lower in the alcoholic group than in the control group (42% vs. 58%; p = 0.013). Among patients with CAD, those with a history of alcoholism had fewer vessels with stenoses (1.6 +/- 0.6 vs. 2.3 +/- 0.7; p < 0.001) than the control group, and were more likely to have single-vessel CAD (64% vs. 8%; p < 0.05). The alcoholic group also had lower mean left ventricular ejection fraction (LVEF) compared to the control group (43 +/- 13% vs. 49 +/- 9%; p < 0.001), and a higher prevalence of left ventricular dysfunction (LVEF < 40%; 37% vs. 13%; p < 0.05). In the alcoholic group, there was a lower prevalence of CAD in patients with left ventricular dysfunction as compared to those without left ventricular dysfunction (21% vs. 49%; p = 0.006).
  
  
  CONCLUSIONS
  In a group of male VA patients presenting with chest pain, alcoholism was associated with a lower incidence and a lesser severity of angiographically-defined CAD, but had greater left ventricular dysfunction. There appears to be an inverse relationship between CAD and left ventricular function in patients with a history of heavy alcohol consumption.
authors.affiliation: S.U.N.Y. Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Spyros
authors.initials: S
authors.lastname: Kokolis
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Marmur
authors.forename: Luther T
authors.initials: LT
authors.lastname: Clark
authors.forename: John
authors.initials: J
authors.lastname: Kassotis
authors.forename: Rodamanthos
authors.initials: R
authors.lastname: Kokolis
authors.forename: Erdal
authors.initials: E
authors.lastname: Cavusoglu
authors.forename: Reuven
authors.initials: R
authors.lastname: Lapin
authors.forename: Sheldon
authors.initials: S
authors.lastname: Breitbart
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lazar
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000503:physiopathology; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D014728:Veterans