Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
J Thromb Haemost. 2018 Sep;16(9):1753-1762. doi: 10.1111/jth.14224. Epub 2018 Aug 12.
Essentials The association of moderate alcohol consumption with pulmonary embolism (PE) risk remains unclear. In three large US cohorts, we evaluated the association of alcohol consumption with PE risk. We found no evidence of an association of alcohol consumption amount or frequency with PE risk. Secondary analyses of type and heavy episodic drinking also yielded null findings.
Background Moderate alcohol consumption has been variably associated with hemostatic and fibrinolytic factor levels, but the association between alcohol consumption and the risk of incident pulmonary embolism (PE) remains uncertain. Objective To evaluate alcohol consumption amount and frequency in relation to PE risk. Methods Nurses' Health Study (NHS), NHS II and Health Professionals Follow-Up Study participants free of venous thromboembolism (VTE) at baseline (n = 217 442) reported alcohol consumption by type, quantity and frequency, every 2-4 years. Incident PE cases were identified by self-report and confirmed for participants without cancer. In this cohort study, we used Cox proportional hazards models to estimate multivariable-adjusted hazard ratios (HRs) for PE associated with alcohol consumption amount and, separately, frequency. Secondary analyses evaluated alcohol type and heavy episodic drinking in relation to PE risk, and amount and frequency in relation to medical record-confirmed idiopathic PE and any self-reported VTE risk. Cohort-specific analyses were pooled using random-effects meta-analysis. Results During ≥ 20 years of follow-up, we identified 1939 PE events. We found no strong evidence of an association between PE risk and alcohol consumption amount (pooled HR for 5.0-14.9 g day vs. abstention = 0.97 [95% CI, 0.79, 1.20]) or frequency (pooled HR for 5-7 drinking days per week vs. abstention = 1.04 [95% CI, 0.88, 1.23]). Secondary analyses of type, heavy episodic drinking, idiopathic PE and VTE also yielded null findings. Conclusions Among three large prospective cohorts of US men and women, we found no evidence of an association between the amount or frequency of alcohol consumption and PE risk.
目的 评估饮酒量和饮酒频率与肺栓塞 (PE) 风险的关系。
方法 护士健康研究 (NHS)、NHS II 和健康专业人员随访研究的参与者在基线时无静脉血栓栓塞症 (VTE) (n = 217442)，通过类型、数量和频率报告饮酒情况，每 2-4 年报告一次。通过自我报告确定 PE 病例，并对无癌症的参与者进行确认。在这项队列研究中，我们使用 Cox 比例风险模型估计与饮酒量相关的多变量调整后的风险比 (HR) 与 PE，以及分别与酒精类型和大量饮酒相关的 PE 风险，评估与 PE 风险相关的饮酒量和频率，以及与医疗记录确诊的特发性 PE 和任何自我报告的 VTE 风险相关的饮酒量和频率。使用随机效应荟萃分析对队列特异性分析进行汇总。
结果 在≥20 年的随访期间，我们发现了 1939 例 PE 事件。我们没有发现强烈的证据表明 PE 风险与饮酒量 (5.0-14.9 g/d 与不饮酒的汇总 HR = 0.97 [95% CI，0.79，1.20]) 或饮酒频率 (每周 5-7 天饮酒与不饮酒的汇总 HR = 1.04 [95% CI，0.88，1.23]) 之间存在关联。对类型、大量饮酒、特发性 PE 和 VTE 的二次分析也得出了无效的结果。
结论 在三个大型前瞻性美国男性和女性队列中，我们没有发现饮酒量或饮酒频率与 PE 风险之间存在关联的证据。
