Alcohol Consumption and Risk of Coronary Artery Disease (From The Million Veteran Program)

Author: Song, Rebecca J; Nguyen, Xuan-Mai T; Quaden, Rachel; Ho, Yuk-Lam; Justice, Amy C; Gagnon, David R; Cho, Kelly; O’Donnell, Christopher J; Concato, John; Gaziano, J. Michael; Djoussé, Luc
Language: English
Published: 2018
Source: PubMed Central (PMC)
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Moderate alcohol consumption has been associated with a lower risk of coronary artery disease (CAD) in the general population, but has not been well studied among U.S. Veterans. We obtained self-reported alcohol consumption from Million Veteran Program participants. Using the electronic health record, CAD events were defined as 1 inpatient or 2 outpatient diagnosis codes for CAD, or 1 code for a coronary procedure. We excluded participants with prevalent CAD (n=69,995) or incomplete alcohol information (n=8,449). We used a Cox Proportional Hazard model to estimate hazard ratios (HR) and 95% confidence intervals (CI) for CAD adjusting for age, sex, body mass index, race, smoking, education, and exercise. Among 156,728 participants, the mean age was 65.3 years (SD=12.1), and 91% were men. There were 6,153 CAD events during a mean follow-up of 2.9 years. Adjusted HRs (95% CI) for CAD were 1.00 (ref), 1.02 (0.92–1.13), 0.83 (0.74–0.93), 0.77 (0.67–0.87), 0.71 (0.62–0.81), 0.62 (0.51–0.76), 0.58 (0.46– 0.74), and 0.95 (0.85–1.06) for categories of never, former, current drinkers of ≤0.5 drink/day, >0.5–1 drink/day, >1–2 drinks/day, >2–3 drinks/day, >3–4 drinks/day, and heavy drinkers (>4 drinks/day)/alcohol use disorder, respectively. For a fixed amount of ethanol, intake at ≥3 days/week was associated with lower CAD risk compared to ≤1 day/week. Beverage preference (beer, wine, liquor) did not influence the alcohol-CAD relation. Our data show a lower risk of CAD with light-to-moderate alcohol consumption among U.S. Veterans, and drinking frequency may provide a further reduction in risk.