Primary Healthcare, ABS Gaudi, Barcelona, Spain.
J Vasc Surg. 2011 Oct;54(4):1081-7. doi: 10.1016/j.jvs.2011.03.285.
The influence of alcohol consumption on outcome in patients with peripheral artery disease (PAD) has not been thoroughly studied.
Factores de Riesgo y ENfermedad Arterial (FRENA) is an ongoing, multicenter, observational registry of consecutive stable outpatients with arterial disease. We compared the mortality rate and the incidence of subsequent ischemic events in patients with PAD, according to their alcohol habits.
As of August 2010, 1073 patients with PAD were recruited, of whom 863 (80%) had intermittent claudication (Fontaine stage II), 102 (9.5%) had rest pain (Fontaine stage III), and 108 (10%) had ischemic skin lesions (Fontaine stage IV). In all, 422 patients (39%) consumed alcohol during the study period. Over a mean follow-up of 13 months, 150 patients (14%) developed subsequent ischemic events (myocardial infarction 28, stroke 30, disabling claudication/critical limb ischemia 100), and 70 patients (6.5%) died. The incidence of subsequent events was the same in both subgroups: 11.8 events per 100 patient-years (rate ratio: 1.00; 95% confidence interval [CI], 0.72-1.41), but the mortality rate was significantly lower in alcohol consumers than in non-consumers: 2.78 vs 6.58 deaths per 100 patient-years (rate ratio: 0.42; 95% CI, 0.23-0.74; P = .002). This better outcome was consistently found in patients with Fontaine stages II and III or IV, and persisted after multivariate adjustment (relative risk: 0.49; 95% CI, 0.28-0.88).
In patients with PAD, moderate alcohol consumption was associated with lower cardiovascular mortality and overall mortality than abstention. These patients should be informed that low to moderate alcohol consumption may not be harmful to their health.
酒精摄入对周围动脉疾病（PAD）患者的预后影响尚未得到充分研究。
动脉疾病风险因素和结局（FRENA）是一项正在进行的、多中心、观察性登记研究，连续纳入有动脉疾病的稳定门诊患者。我们根据患者的饮酒习惯比较了 PAD 患者的死亡率和随后发生缺血事件的发生率。
截至 2010 年 8 月，共纳入 1073 例 PAD 患者，其中 863 例（80%）间歇性跛行（Fontaine Ⅱ期），102 例（9.5%）静息痛（Fontaine Ⅲ期），108 例（10%）缺血性皮肤病变（Fontaine Ⅳ期）。共有 422 例（39%）患者在研究期间饮酒。平均随访 13 个月期间，150 例（14%）发生了随后的缺血事件（心肌梗死 28 例，卒中 30 例，致残性跛行/严重肢体缺血 100 例），70 例（6.5%）死亡。两组的随后事件发生率相同：每 100 例患者年发生 11.8 例事件（发生率比值：1.00；95%置信区间 [CI]，0.72-1.41），但饮酒者的死亡率明显低于非饮酒者：每 100 例患者年死亡 2.78 例与 6.58 例（发生率比值：0.42；95%CI，0.23-0.74；P=0.002）。这种更好的结果在 Fontaine Ⅱ期和Ⅲ期或Ⅳ期患者中始终存在，并且在多变量调整后仍然存在（相对风险：0.49；95%CI，0.28-0.88）。
在 PAD 患者中，与戒酒相比，适量饮酒与较低的心血管死亡率和总死亡率相关。应告知这些患者，低至中度饮酒可能不会对他们的健康造成危害。
