Harvard Medical School, Boston, Massachusetts, USA.
Am J Cardiol. 2012 Jan 15;109(2):147-52. doi: 10.1016/j.amjcard.2011.08.021. Epub 2011 Oct 18.
Although moderate alcohol drinkers have lower rates of incident coronary artery disease than abstainers, much less is known about the health effects of different patterns of alcohol use in women with established coronary artery disease. In the Determinants of Myocardial Infarction Onset Study, 1,253 women hospitalized for acute myocardial infarction (MI) at 64 centers nationwide from 1989 to 1996 were followed for mortality through December 31, 2007. Of the women, 761 (61%) reported abstention in the year before their MIs, 280 (22%) reported consumption of <1 serving/week, 75 (6%) reported consumption of 1 to 3 servings/week, and 137 (11%) reported consumption of ≥3 servings/week. Using Cox proportional-hazards models, the associations between total weekly volume of consumption, drinking days per week, drinks per drinking day, and beverage type with 10-year mortality were investigated, adjusting for clinical and socioeconomic potential confounders. Compared with abstention, adjusted hazard ratios were 0.66 (95% confidence interval 0.50 to 0.86) for <1 serving/week, 0.65 (95% confidence interval 0.38 to 1.11) for 1 to 3 servings/week, and 0.65 (95% confidence interval 0.38 to 1.11) for ≥3 servings/week (p for trend = 0.008). No differences were found by beverage type, and generally inverse associations of drinking frequency and quantity with mortality were found. In conclusion, in women who survive MI, moderate drinking is associated with a decreased risk for mortality, with no clear differences on the basis of pattern or beverage type. These results suggest that women who survive MI need not abstain from alcohol, but any derived benefit would appear to occur well below currently recommended limits in alcohol consumption.
尽管适量饮酒者患冠心病的发生率低于不饮酒者，但对于已患有冠心病的女性，不同饮酒模式对健康的影响却知之甚少。在心肌梗死发病决定因素研究中，1989 年至 1996 年间，全国 64 个中心因急性心肌梗死（MI）住院的 1253 名女性在 2007 年 12 月 31 日之前进行了死亡率随访。其中，761 名（61%）女性报告在心肌梗死前一年滴酒不沾，280 名（22%）女性报告每周饮酒量<1 份，75 名（6%）女性报告每周饮酒 1-3 份，137 名（11%）女性报告每周饮酒量≥3 份。采用 Cox 比例风险模型，调整临床和社会经济潜在混杂因素后，研究了每周总饮酒量、每周饮酒天数、每天饮酒量和饮料类型与 10 年死亡率之间的关系。与不饮酒相比，每周饮酒量<1 份、每周饮酒 1-3 份和每周饮酒量≥3 份的调整后危险比分别为 0.66（95%置信区间 0.50-0.86）、0.65（95%置信区间 0.38-1.11）和 0.65（95%置信区间 0.38-1.11）（趋势检验 P 值=0.008）。不同类型的饮料与死亡率无差异，且饮酒频率和量与死亡率之间存在反比关系。总之，在存活的心肌梗死女性中，适度饮酒与死亡率降低相关，而饮酒模式或饮料类型并无明显差异。这些结果表明，存活的心肌梗死女性无需戒酒，但任何益处似乎都低于目前推荐的饮酒限量。
