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Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: the Second Manifestations of ARTerial (SMART) disease study.
Atherosclerosis. 2010 Sep; 212(1):281-6.A

Abstract

OBJECTIVE

This study investigated the relation between alcohol consumption and specific vascular events and mortality in a high risk population of patients with clinical manifestations of vascular disease and diabetes.

METHODS

Patients with clinically manifest vascular disease or diabetes (n=5447) from the SMART study were followed for cardiovascular events and mortality. Alcohol consumption was assessed with a baseline questionnaire and analysed in relation with coronary heart disease (CHD), amputations, stroke, and all-cause and vascular death.

RESULTS

After a follow up of 4.7 years, we documented 363 cases of CHD, 187 cases of stroke, 79 amputations and 641 cases of all-cause death, of which 382 were vascular. In multivariate-adjusted models, alcohol consumption was inversely associated with CHD (p(linear trend)=0.007) and stroke (p(linear trend)=0.051) with respective hazard ratios of 0.39 (95%CI: 0.20-0.76) and 0.67 (0.31-1.46) for consuming 10-20 drinks/week compared with abstainers. We observed significant U-shaped associations between alcohol consumption and amputations (p(quadratic trend)=0.001), all-cause death (p(quadratic trend)=0.001) and vascular death (p(quadratic trend)=0.013). Hazard ratios for consuming 10-20 drinks/week were 0.29 (0.07-1.30) for amputations, 0.40 (0.24-0.69) for all-cause death and 0.34 (0.16-0.71) for vascular death compared with abstainers. Similar associations were observed for red wine consumption only.

CONCLUSION

Moderate alcohol consumption (1-2 drinks/day) is not only associated with a reduced risk of vascular and all-cause death in a high risk patients with clinical manifestations of vascular disease, but also with reduced risks of non-fatal events like CHD, stroke and possibly amputations.

Authors+Show Affiliations

Julius Center for Health Sciences and Primary Care, UMC Utrecht, The Netherlands. j.beulens@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20537650

Citation

Beulens, J W J., et al. "Alcohol Consumption and Risk of Recurrent Cardiovascular Events and Mortality in Patients With Clinically Manifest Vascular Disease and Diabetes Mellitus: the Second Manifestations of ARTerial (SMART) Disease Study." Atherosclerosis, vol. 212, no. 1, 2010, pp. 281-6.
Beulens JW, Algra A, Soedamah-Muthu SS, et al. Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: the Second Manifestations of ARTerial (SMART) disease study. Atherosclerosis. 2010;212(1):281-6.
Beulens, J. W., Algra, A., Soedamah-Muthu, S. S., Visseren, F. L., Grobbee, D. E., & van der Graaf, Y. (2010). Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: the Second Manifestations of ARTerial (SMART) disease study. Atherosclerosis, 212(1), 281-6. https://doi.org/10.1016/j.atherosclerosis.2010.04.034
Beulens JW, et al. Alcohol Consumption and Risk of Recurrent Cardiovascular Events and Mortality in Patients With Clinically Manifest Vascular Disease and Diabetes Mellitus: the Second Manifestations of ARTerial (SMART) Disease Study. Atherosclerosis. 2010;212(1):281-6. PubMed PMID: 20537650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: the Second Manifestations of ARTerial (SMART) disease study. AU - Beulens,J W J, AU - Algra,A, AU - Soedamah-Muthu,S S, AU - Visseren,F L J, AU - Grobbee,D E, AU - van der Graaf,Y, AU - ,, Y1 - 2010/05/06/ PY - 2010/01/08/received PY - 2010/04/06/revised PY - 2010/04/27/accepted PY - 2010/6/12/entrez PY - 2010/6/12/pubmed PY - 2010/12/29/medline SP - 281 EP - 6 JF - Atherosclerosis JO - Atherosclerosis VL - 212 IS - 1 N2 - OBJECTIVE: This study investigated the relation between alcohol consumption and specific vascular events and mortality in a high risk population of patients with clinical manifestations of vascular disease and diabetes. METHODS: Patients with clinically manifest vascular disease or diabetes (n=5447) from the SMART study were followed for cardiovascular events and mortality. Alcohol consumption was assessed with a baseline questionnaire and analysed in relation with coronary heart disease (CHD), amputations, stroke, and all-cause and vascular death. RESULTS: After a follow up of 4.7 years, we documented 363 cases of CHD, 187 cases of stroke, 79 amputations and 641 cases of all-cause death, of which 382 were vascular. In multivariate-adjusted models, alcohol consumption was inversely associated with CHD (p(linear trend)=0.007) and stroke (p(linear trend)=0.051) with respective hazard ratios of 0.39 (95%CI: 0.20-0.76) and 0.67 (0.31-1.46) for consuming 10-20 drinks/week compared with abstainers. We observed significant U-shaped associations between alcohol consumption and amputations (p(quadratic trend)=0.001), all-cause death (p(quadratic trend)=0.001) and vascular death (p(quadratic trend)=0.013). Hazard ratios for consuming 10-20 drinks/week were 0.29 (0.07-1.30) for amputations, 0.40 (0.24-0.69) for all-cause death and 0.34 (0.16-0.71) for vascular death compared with abstainers. Similar associations were observed for red wine consumption only. CONCLUSION: Moderate alcohol consumption (1-2 drinks/day) is not only associated with a reduced risk of vascular and all-cause death in a high risk patients with clinical manifestations of vascular disease, but also with reduced risks of non-fatal events like CHD, stroke and possibly amputations. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/20537650/Alcohol_consumption_and_risk_of_recurrent_cardiovascular_events_and_mortality_in_patients_with_clinically_manifest_vascular_disease_and_diabetes_mellitus:_the_Second_Manifestations_of_ARTerial__SMART__disease_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(10)00325-4 DB - PRIME DP - Unbound Medicine ER -