J Clin Med. 2024;13(21):jcm13216542.

Impact of Alcohol Consumption on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention.

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제1저자 윤준필, 한경도 · 교신저자 한정규

PMID 39518680 PMC11546366 DOI 10.3390/jcm13216542 IF 3.3 순환기내과

소속 (4)

Cardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea.
Uijeongbu Eulji Medical Center, Uijeongbu-si 11749, Gyeonggi-do, Republic of Korea.
Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.

Abstract

Background/Objectives: The impact of alcohol consumption and its restriction on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) remains elusive. We aimed to investigate the clinical outcomes in drinkers undergoing PCI. Methods: We included 77,409 patients who underwent PCI and a health check-up within one year of the PCI using a nationwide prospective database from the Korean National Health Insurance System. Primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction, coronary revascularization, and stroke. Patients were classified as non-drinkers, within-the-guideline (≤1 standard drink in women and ≤2 in men), and above-the-guideline drinkers based on drinking status at the first health check-up after PCI. Results: During a 4.0-year follow-up duration, MACCE incidence was 19.7% (n = 15,214) (4689 [6.1%] deaths, 1916 [2.5%] MI, 2033 [2.6%] strokes, and 10,086 [13.0%] revascularizations). Both within-the-guideline- (aHR [95%CI], 0.843 [0.773-0.919]) and above-the-guideline drinkers (0.829 [0.784-0.876]) had a lower MACCE risk than the non-drinkers. A characteristic J-curve relationship was observed between the frequency or body weight-adjusted alcohol consumption and MACCE risk, with the lowest risk in the once-per-week and a mild amount per body weight (≤0.33 g/kg/week) group. Drinking habits after PCI were associated with a lower risk of adverse cardiovascular outcomes; those who continued to drink before and after PCI had the lowest risk. Conclusions: Alcohol consumption was associated with a lower risk of adverse outcomes in patients undergoing PCI. Further studies with longer-term follow-up are warranted.

Keywords

PCIalcohol consumptioncardiovascular risk

Figures

**Figure 1** Study flow chart. We included 77,409 patients who underwent PCI and a health checkup within one year of the index PCI. Patients were classified as non-drinkers, within-the-guideline (≤1 standard drink in women and ≤2 in men), and above-the-guideline drinkers based on drinking status at the first health check-up after PCI. PCI, percutaneous coronary intervention.

**Figure 2** The Kaplan–Meier Curves for MACCE According to Drinking Status in Crude (A) and IPW-matched Populations (B). The Kaplan–Meier curves demonstrated the highest MACCE incidence in non-drinkers and the lowest in above-the-guideline drinkers in both the crude and IPW populations (log-rank p < 0.001). n = 77,409. A log-rank test was utilized for statistical analyses. IPW, inverse probability-weighted; MACCE, major adverse cardiovascular and cerebrovascular events.

**Figure 3** MACCE risk according to frequency (times per week) (A) and bodyweight-adjusted amount of drinking (B). Drinking frequency, defined by the number of drinks consumed per week, showed a J-curve relationship with the IPW-aHR of MACCE. The MACCE risk was the lowest in patients who drank alcohol once a week and gradually increased with alcohol intake frequency. (A) When weekly alcohol intake per body weight was divided into quintiles, a J-curve relationship was also found between body weight-adjusted drinking amount and clinical outcomes. (B) Q1, ≤0.33g/kg/week; Q2, 0.33g/kg/week ˂ to ≤0.63g/kg/week; Q3, 0.63g/kg/week ˂ to ≤1.09g/kg/week; Q4, 1.09g/kg/week ˂ to ≤2.11g/kg/week; Q5, >2.11 g/kg/week. n = 77,409. The Multivariable Cox regression model was utilized for statistical analyses. HR, hazard ratio; IPW, inverse probability-weighted; MACCE, major adverse cardiovascular and cerebrovascular events.

**Figure 4** Subgroup analysis for MACCE. Lower drinking habit-associated MACCE risk was consistently observed across various subgroups, including sex, age, hypertension, diabetes mellitus, and dyslipidemia in the IPW-matched population. n = 77,409. A weighted Cox regression model was utilized to produce the p-values. MACCE, major adverse cardiovascular and cerebrovascular events.

그림 출처: PubMed Central 공개 논문 (PMC11546366)

Conflict of interest statement

The authors report no relationships that could be construed as a conflict of interest.

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