Details
Category: Volume 06 Issue 11 November 2018
Hits: 999

Title: Does Heavy Consumption of alcohol worsen the prognosis of Acute Myocardial Infarction? – An observational study undertaken in a rural South Indian Population

Authors: Natesan Chidambaram, Rakesh Sebastin Xavier, Nadanam Saravanan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.99

Abstract

Although epidemiological evidence for the beneficial effects of low alcohol consumption on coronary artery diseases is strong, the impact of heavy drinking is less clear. There are plenty of evidences regarding the impact of alcohol consumption on acute myocardial infarction (AMI). The objective of the study is to determine the association of heavy alcohol consumption among patients with AMI with reference to Left Ventricular Ejection Fraction (LVEF), admitted at Rajah Muthiah Medical College Hospital, Annamalai University, Annamalai nagar, India. Adult inpatients to the hospital with clinical features suggestive of AMI were enrolled in this study. The total number of patients was one hundred. A detailed history was recorded and physical examination was carried out. Relevant investigations, i.e Electrocardiogram, Cardiac markers including Troponin-T, Creatine Phosphokinase (CPK-MB) and Echocardiogram were done. It was observed that the complexity of disease was significantly high in patients with history of heavy alcohol consumption. These patients were prone for high systolic and diastolic blood pressure, sinus tachycardia and high activity of CPK-MB and positive troponin-T. Captivatingly, most of the patients with a history of heavy alcohol consumption had reduced LVEF indicating the severity of Left ventricular (LV) dysfunction which was statistically significant. LV failure, with a poor prognosis, is strongly associated with LV dysfunction. These findings append to the already reputable fact that heavy alcohol consumption is a major risk factor for coronary artery disease and a predictor of poor prognosis of AMI. 

Keywords: Alcohol, Acute Myocardial Infarction, Creatine Phosphokinase, Troponin-T, Left Ventricular Ejection Fraction, Left Ventricular Dysfunction. 

References

  1. World Health Organization. The WHO Mortality Database. Geneva: WHO, 2015.
  2. Thygesen K, Alpert JS, White HD. “Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction.” Eur Heart J. 28: 2525-2538, 2007.
  3. Mahmood SS, Levy D, Vasan RS, Wang TJ. “The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective.” Lancet. 383:999-1008, 2014.
  4. Anand SS, Islam S, Rosengren A, Steyn K, Yusufali AH, et al; “INTERHEART Investigators. Risk factors for myocardial infarction in women and men: insights from the INTERHEART study.” Eur Heart J. 29:932-40, 2008.
  5. Lim SS, Vos T, Flaxman AD, Danaei G, et al. “A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.” Lancet. 380:2224–2260, 2012.
  6. Leon DA, Saburova L, Tomkins S, Andreev E, Kiryanov N, McKee M, Shkolnikov VM. “Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study.” Lancet. 369:2001–2009, 2007.
  7. Leong DP, Smyth A, Teo KK, McKee M, Rangarajan S, Pais P et al. “INTERHEART Investigators. Patterns of alcohol consumption and myocardial infarction risk: observations from 52 countries in the INTERHEART case-control study.” Circulation. 130:390-8, 2014.
  8. Anand SS, Islam S, Rosengren A, Steyn K, Yusufali AH, et al. “INTERHEART Investigators. Risk factors for myocardial infarction in women and men: insights from the INTERHEART study.” Eur Heart J. 29:932-40, 2008.
  9. McKee M, Britton A. “The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms.” J R Soc Med. 91:402–407, 1998.
  10. Hillbom M, Kangasaho M, Löwbeer C, Kaste M, Muuronen A, Numminen H. “Effects of ethanol on platelet function.” Alcohol. 2:429–432, 1985.
  11. McKee M, Britton A. “The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms.” J R Soc Med. 91:402–407, 1998.
  12. Barden AE, Croft KD, Beilin LJ, Phillips M, Ledowski T, Puddey IB. “Acute effects of red wine on cytochrome P450 eicosanoids and blood pressure in men.” J Hypertens. 31:2195–202, 2013.
  13. Lang RM, Bierig M, Devereux RB, et al. “Recommendations for chamber quantification: a report from the American Society of Echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European association of echocardiography, a branch of the European Society of Cardiology.” J Am Soc Echocardiogr. 18(12):1440–63,2005.
  14. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.
  15. British Heart Foundation website. High blood pressure. Available at: http://www.bhf.org.uk/heart-health/conditions/high-blood-pressure.aspx
  16. British Heart Foundation website. Dilated cardiomyopathy. Available at: http://www.bhf.org.uk/heart-health/conditions/cardiomyopathy/dilated-cardiomyopathy.aspx
  17. NHS Choices website. Heart failure. The Information Standard member organisation. Last reviewed: 02/09/2014. Available at: http://www.nhs.uk/Conditions/Heart-failure/Pages/Introduction.aspx
  18. Wendy RS and Robert HC. “Cardiac and Muscle disease. In: Clinical Chemistry” (Theory, Analysis, Correlation) (4th ed). Kaplan la, Pesce AJ, Kazmierczak SC. Mosby. 2003.
  19. Hamm, C.W. and E. Braunwald. “A classification of unstable angina revisited.” Circulation. 102: 118-122, 2000.
  20. Gupta S, Singh KN, Bapat V, Mishra V, Agarwal DK and Gupta P. “Diagnosis of acute myocardial infarction: CK- MB versus CTN-T in Indian patients.” Ind. J. Clin. Biochem. 23: 89-91, 2008.
  21. Robert J. Siegel, MD, Miriam Kligerman, BS, L. Julian Haywood, MD, and William E. Shell, MD. “Increased MB.Creatine kinase isoenzymes in an alcoholic population.” Journal of the National Medical Association, 77: 6, 1985.
  22. Regan TJ, Haider B. “Ethanol abuse and heart disease.” Circulation, 64 Suppl III:III-14 –9, 1981.
  23. Urbano-Marquez A, Estruch R, Navarro-Lopez F, Grau JM, Mont L, Rubin E. “The effects of alcoholism on skeletal and cardiac muscle.” N Engl J Med, 321:1048 –50, 1989.
  24. Sanderson JE, Jones JV, Graham DI. “Effect of chronic alcohol ingestion on the heart and blood pressure of spontaneously hypertensive rats.” Clin Exp Hypertens. A5:673– 89, 1983.

Corresponding Author

Dr Nadanam. Saravanan

Cell: +91 9842193626, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.