Faris R F, Henein M Y, Coats A J S
Department of Clinical Cardiology, Royal Brompton Hospital, London, United Kingdom.
Heart Dis. 2003 Mar-Apr;5(2):89-94. doi: 10.1097/01.hdx.0000061702.79961.47.
Between 1994-1998, we retrospectively studied a cohort of 396 consecutive patients with dilated cardiomyopathy, mean age 53 +/- 15 years, 74% men. The history of alcohol intake was abstracted from the medical records. During a follow-up period of 42 +/- 26 months, 83 (76% men) patients died and 15 (80% men) underwent cardiac transplantation. Men were younger and more likely to have a history of excessive alcohol intake compared with women. Gender significantly modified the risk of alcohol consumption on mortality. Although alcohol intake increased the mortality risk in women, it was protective toward death in men (hazards ratios for death were 7.3 vs. 0.44). The effect of alcohol intake on outcome was reassessed after classifying the patients into 4 groups: group 1: life-long nondrinkers; group 2: former drinkers; group 3: moderate drinkers; and group 4: heavy drinkers. Similar findings were seen. This study demonstrated that the risk of reported alcohol intake on mortality is related to gender in patients with nonischemic heart failure. Our findings deserve further study, including a larger number of females, as a possible way to improve outcome in such patients.
1994年至1998年期间,我们对连续396例扩张型心肌病患者进行了回顾性研究,这些患者的平均年龄为53±15岁,男性占74%。饮酒史从病历中提取。在42±26个月的随访期内,83例(76%为男性)患者死亡,15例(80%为男性)接受了心脏移植。与女性相比,男性更年轻,且更有可能有过量饮酒史。性别显著改变了饮酒对死亡率的影响。虽然饮酒会增加女性的死亡风险,但对男性的死亡具有保护作用(死亡风险比分别为7.3和0.44)。将患者分为4组后重新评估了饮酒对预后的影响:第1组:终生不饮酒者;第2组:既往饮酒者;第3组:适度饮酒者;第4组:重度饮酒者。观察到了类似的结果。这项研究表明,在非缺血性心力衰竭患者中,报告的饮酒对死亡率的影响与性别有关。我们的研究结果值得进一步研究,包括纳入更多女性,这可能是改善此类患者预后的一种方法。