title: Risk of myocardial infarction immediately after alcohol consumption.
abstract: BACKGROUND
  Habitual moderate alcohol consumption is associated with a lower risk of acute myocardial infarction (MI), whereas heavy (binge) drinking is associated with higher cardiovascular risk. However, less is known about the immediate effects of alcohol consumption on the risk of acute MI and whether any association differs by beverage type or usual drinking patterns.
  
  
  METHODS
  We conducted a case-crossover analysis of 3869 participants from the Determinants of Myocardial Infarction Onset Study who were interviewed during hospitalization for acute MI in one of the 64 medical centers across the United States in 1989-1996. We compared the observed number of times that each participant consumed wine, beer, or liquor in the hour preceding MI symptom onset with the expected frequency based on each participant's control information, defined as the number of times the participant consumed alcohol in the past year.
  
  
  RESULTS
  Among 3869 participants, 2119 (55%) reported alcohol consumption in the past year, including 76 within 1 hour before acute MI onset. The incidence rate of acute MI onset was elevated 1.72-fold (95% confidence interval [CI] = 1.37-2.16) within 1 hour after alcohol consumption. The association was stronger for liquor than for beer or wine. The higher rate was not apparent for daily drinkers. For the 24 hours after consumption, there was a 14% lower rate (relative risk = 0.86 [95% CI = 0.79-0.95]) of MI compared with periods with no alcohol consumption.
  
  
  CONCLUSIONS
  Alcohol consumption is associated with an acutely higher risk of MI in the subsequent hour among people who do not typically drink alcohol daily.
authors.affiliation: From the aCardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; bDepartment of Epidemiology, Harvard School of Public Health, Boston, MA; cDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; dCenter for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands; eDivision of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA; fDepartment of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada; gDepartment of Cardiology, Royal North Shore Hospital, Sydney, Australia; and hInfraReDx, Burlington, MA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mostofsky
authors.forename: Johanna G
authors.initials: JG
authors.lastname: van der Bom
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: Malcolm
authors.initials: M
authors.lastname: Maclure
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Tofler
authors.forename: James E
authors.initials: JE
authors.lastname: Muller
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000434:Alcoholic Beverages / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology