Department of Neurology, Dongying People's Hospital, Dongying, Shandong Province, China.
Department of Oncology, Dongying People's Hospital, Dongying, Shandong Province, China.
Postgrad Med. 2021 Mar;133(2):154-159. doi: 10.1080/00325481.2020.1805945. Epub 2020 Aug 23.
Alcohol consumption is a risk factor for stroke. However, there are no available data on the effect of alcohol consumption on the long-term outcome of ischemic stroke in China. Therefore, this study aimed to explore the association of alcohol consumption with the prognosis of ischemic stroke by subtype in different follow-up periods after stroke.
This 12-month follow-up study recruited 3830 acute ischemic stroke patients from Tianjin, China, between 2016 and 2018. Patients were categorized into two groups according to their consumption of alcohol. Differences in mortality, recurrence, and dependency rates at 3 and 12 months after stroke were compared between both groups.
The mortality, recurrence, and dependency rates at 12 months after stroke were significantly higher in patients who previously consumed alcohol than in those without previous alcohol consumption (all P < 0.005). A similar trend was observed for mortality rate at 3 months after stroke (P < 0.001). The risk of death at 3 months after an atherothrombotic stroke decreased by 63.4% (relative risk [RR], 0.366; 95% confidence interval [CI], 0.144-0.935) among patients who previously consumed alcohol compared with those who never consumed alcohol. Moreover, for patients with small artery disease classified according to the Trial of ORG 10,172 in Acute Stroke Treatment (TOAST), the recurrence and dependency rates at 12 months after stroke decreased by 49.2% (RR, 0.508; 95% CI, 0.259-0.996) and 49.5% (RR, 0.505; 95% CI, 0.258-0.990), respectively, among patients who consumed alcohol.
Previous alcohol consumption decreased the risk of death at 3 months after stroke among patients with atherothrombotic stroke according to the TOAST classification. Furthermore, for patients with small artery disease (according to TOAST classification), alcohol consumption significantly decreased the risk of recurrence and dependency at 12 months after stroke. This study highlights an urgent need to quantify the association of alcohol consumption with outcomes after stroke in China to improve stroke prognosis.
饮酒是中风的一个危险因素。然而，目前尚无关于饮酒对中国缺血性中风患者长期预后影响的可用数据。因此，本研究旨在探讨不同随访期内饮酒与中风后不同亚型缺血性中风患者预后的关系。
本研究为 12 个月随访研究，纳入 2016 年至 2018 年期间来自中国天津的 3830 例急性缺血性脑卒中患者。根据饮酒情况将患者分为两组。比较两组患者中风后 3 个月和 12 个月时死亡率、复发率和依赖性发生率的差异。
中风后 12 个月时，既往饮酒患者的死亡率、复发率和依赖性发生率均显著高于无饮酒史者（均 P < 0.005）。中风后 3 个月时死亡率也呈现出类似趋势（P < 0.001）。与从不饮酒者相比，既往饮酒的动脉粥样硬化血栓性中风患者死亡风险在 3 个月时降低了 63.4%（相对风险 [RR]，0.366；95%置信区间 [CI]，0.144-0.935）。此外，对于根据组织型纤溶酶原激活剂治疗急性缺血性脑卒中试验（TOAST）分类的小动脉疾病患者，饮酒患者中风后 12 个月时的复发率和依赖性发生率分别降低了 49.2%（RR，0.508；95%CI，0.259-0.996）和 49.5%（RR，0.505；95%CI，0.258-0.990）。
TOAST 分类的动脉粥样硬化血栓性中风患者既往饮酒可降低中风后 3 个月时的死亡风险。此外，对于小动脉疾病（TOAST 分类）患者，饮酒可显著降低中风后 12 个月时的复发和依赖性风险。本研究强调迫切需要在中国量化饮酒与中风后结局的关系，以改善中风预后。
