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Am J Cardiol. 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).

Author information

1
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts. Electronic address: Rebecca.Song@va.gov.
2
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
3
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts.
4
Veterans Aging Cohort Study Coodring Center, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Internal Medicine, Yale University Schools of Medicine and Public Health, New Haven, Connecticut; Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut.
5
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
6
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; National Heart, Lung, and Blood Institute, National Institutes of Health, Boston, Massachusetts.
7
Department of Internal Medicine, Yale University Schools of Medicine and Public Health, New Haven, Connecticut; Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut.
8
VA Boston Healthcare System.
9
VA Connecticut Health Care System.
10
Durham VA Medical Center.
11
VA New York Harbor Healthcare System.
12
N. FL/S. GA Veterans Health System.
13
VA Palo Alto Health Care System.
14
VA Puget Sound Health Care System.
15
VA Western New York Healthcare System.
16
Minneapolis VA Health Care System.
17
Birmingham VA Medical Center.
18
Bay Pines VA Healthcare System.
19
VA Health Care System Upstate New York.
20
Michael E. DeBakey VA Medical Center.
21
Ralph H. Johnson VA Medical Center.
22
Miami VA Health Care System.
23
Kansas City VA Medical Center.
24
New Mexico VA Health Care System.
25
Atlanta VA Medical Center.
26
VA Long Beach Healthcare System.
27
Tuscaloosa VA Medical Center.
28
W.G. (Bill) Hefner VA Medical Center.
29
VA Salt Lake City Health Care System.
30
South Texas Veterans Health Care System.
31
Louis Stokes Cleveland VA Medical Center.
32
Portland VA Medical Center.
33
Washington DC VA Medical Center.
34
Clement J. Zablocki VA Medical Center.
35
Wm. Jennings Bryan Dorn VA Medical Center.
36
Central Arkansas Veterans Health Care System.
37
Richard Roudebush VA Medical Center.
38
Phoenix VA Health Care System.
39
VA San Diego Healthcare System.
40
Overton Brooks VA Medical Center.
41
VA Eastern Kansas Health Care System.
42
VA Tennessee Valley Healthcare System.
43
VA Greater Los Angeles Health Care System.
44
VA Eastern Colorado Health Care System.
45
Central Texas Veterans Health Care System; VA Pittsburgh Health Care System.
46
Southern Arizona VA Health Care System.
47
Memphis VA Medical Center.
48
Hunter Holmes McGuire VA Medical Center.
49
VA Maryland Health Care System.
50
VA North Texas Health Care System.
51
Edward Hines, Jr. VA Medical Center.
52
VA Loma Linda Healthcare System.
53
Hampton VA Medical Center.
54
Philadelphia VA Medical Center.
55
VA Caribbean Healthcare System.
56
James A. Haley Veterans' Hospital.
57
Cincinnati VA Medical Center.
58
Central Western Massachusetts Healthcare System.
59
White River Junction VA Medical Center.
60
William S. Middleton Memorial Veterans Hospital.
61
St. Louis VA Health Care System.
62
Edith Nourse Rogers Memorial Veterans Hospital.
63
Iowa City VA Health Care System.
64
VA Maine Healthcare System.
65
Northport VA Medical Center.
66
Manchester VA Medical Center.
67
Louisville VA Medical Center.
68
Orlando VA Medical Center.
69
Jack C. Montgomery VA Medical Center.
70
Providence VA Medical Center.
71
Salem VA Medical Center.
72
San Francisco VA Health Care System.
73
Fayetteville VA Medical Center.
74
Brecksville; VA Pittsburgh VA Healthcare System.

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.

PMID:
29580627
DOI:
10.1016/j.amjcard.2018.01.042
[Indexed for MEDLINE]

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