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. 2018 May 15;121(10):1162-1168.
doi: 10.1016/j.amjcard.2018.01.042. Epub 2018 Feb 12.

Alcohol Consumption and Risk of Coronary Artery Disease (from the Million Veteran Program)

Rebecca J Song  1 , Xuan-Mai T Nguyen  2 , Rachel Quaden  3 , Yuk-Lam Ho  3 , Amy C Justice  4 , David R Gagnon  5 , Kelly Cho  2 , Christopher J O'Donnell  6 , John Concato  7 , J Michael Gaziano  2 , Luc Djoussé  2 ; VA Million Veteran Program
Collaborators, Affiliations

Alcohol Consumption and Risk of Coronary Artery Disease (from the Million Veteran Program)

Rebecca J Song et al. Am J Cardiol. .

Abstract

Moderate alcohol consumption has been associated with a lower risk of coronary artery disease (CAD) in the general population but has not been well studied in US veterans. We obtained self-reported alcohol consumption from Million Veteran Program participants. Using electronic health records, CAD events were defined as 1 inpatient or 2 outpatient diagnosis codes for CAD, or 1 code for a coronary procedure. We excluded participants with prevalent CAD (n = 69,995) or incomplete alcohol information (n = 8,449). We used a Cox proportional hazards model to estimate hazard ratios and 95% confidence intervals for CAD, adjusting for age, gender, body mass index, race, smoking, education, and exercise. Among 156,728 participants, the mean age was 65.3 years (standard deviation = 12.1) and 91% were men. There were 6,153 CAD events during a mean follow-up of 2.9 years. Adjusted hazard ratios (95% confidence intervals) for CAD were 1.00 (reference), 1.02 (0.92 to 1.13), 0.83 (0.74 to 0.93), 0.77 (0.67 to 0.87), 0.71 (0.62 to 0.81), 0.62 (0.51 to 0.76), 0.58 (0.46 to 0.74), and 0.95 (0.85 to 1.06) for categories of never drinker; former drinker; current drinkers of ≤0.5 drink/day, >0.5 to 1 drink/day, >1 to 2 drinks/day, >2 to 3 drinks/day, and >3 to 4 drinks/day; and heavy drinkers (>4 drinks/day) or alcohol use disorder, respectively. For a fixed amount of ethanol, intake at ≥3 days/week was associated with lower CAD risk compared with ≤1 day/week. Beverage preference (beer, wine, or liquor) did not influence the alcohol-CAD relation. Our data show a lower risk of CAD with light-to-moderate alcohol consumption among US veterans, and drinking frequency may provide a further reduction in risk.

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Conflict of interest statement

Disclosures

This publication does not represent the views of the Department of Veterans Affairs or the United States Government. There are no conflicts of interests to disclose.

Figures

Figure 1.
Figure 1.
Spline regression of ethanol (g/day) intake and hazard ratios (95%CI) for coronary artery disease, adjusted for age, body mass index, sex, education, exercise, white race. Knots are placed at 12, 24, and 36 grams/day.
Figure 2.
Figure 2.
Spline regression of ethanol (g/day) intake and hazard ratios (95%CI) for coronary artery disease stratified by sex and stratified by white and black race, adjusted for age, body mass index, white race, and education. Knots are placed at 12, 24, and 36 grams/day for both stratified spline regressions.
See this image and copyright information in PMC

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