Denmark: VF Risk at STEMI Rises with Above-Moderate Alcohol Intake

Although alcohol is inversely associated with myocardial infarction (MI) across all levels of intake, the relationship with sudden cardiac death (SCD) is U-shaped with lower risks only observed at light to moderate levels of alcohol intake raising the hypothesis that higher levels of intake may be proarrhythmic. To address this hypothesis, we examined the association between alcohol intake and ventricular fibrillation (VF) among patients presenting with ST-elevation myocardial infarction (STEMI).

Patients presenting with first STEMI between the ages of 18 and 80 who were treated with primary percutaneous intervention (PCI) were enrolled at all four PCI centers in Denmark in a case control study. The average alcohol intake among patients presenting with VF within the first 12 hours of STEMI before PCI (cases, n=219) was compared to that among patients who did not have VF during this time period (controls, n=441) using multivariable logistic regression. Research coordinators collected information on the average frequency of alcohol intake per week prior to MI via questionnaires. One unit of alcohol (12 g) is defined as a beer, a single measure of spirits, or a glass of wine.

Habitual alcohol consumption above 7 units of alcohol per week was an independent risk factor for VF. These data support the hypothesis that alcohol consumption beyond a moderate level of intake may lower the threshold for VF in the setting of myocardial ischemia.