Risk Factors for Sudden Cardiac Death Among Patients with Alcohol Dependence: A Nested Case–Control Study. (24th July 2015)

• Record Type: Journal Article
• Authors: Wu, Shu‐I; Tsai, Shang‐Ying; Huang, Ming‐Chyi; Stewart, Robert; Kuo, Chian‐Jue; Chen, Chiao‐Chicy
• Is Part Of: Alcoholism. Volume 39:Number 9(2015:Sep.)
• Page Start: 1797
• Page End: 1804
• Publication Date: 2015-07-24
• Subjects: Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.12820
• Languages: English
• ISSNs: 0145-6008

Abstract

<abstract abstract-type="main" id="acer12820-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acer12820-sec-0001" sec-type="section"> <title>Background</title> <p>Excessive alcohol consumption causes a broad range of health problems, including premature mortality and sudden cardiac death (SCD). We identified potential clinical characteristics and laboratory indices associated with SCD among patients with alcohol dependence.</p> </sec> <sec id="acer12820-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients with alcohol dependence (<italic>n</italic> = 2, 793) admitted to a psychiatric center in northern Taiwan between 1985 and 2008 were linked with a national mortality database for causes of death. Of the 2, 793 patients in the cohort, 67 cases died of SCD. The standardized mortality ratio (SMR) of SCD relative to the general population was calculated. Based on a nested case–control design, we selected a set of sex‐, age‐, and year‐of‐admission‐matched two control subjects for each case derived from the cohort. We collated the clinical information through a standardized review of patients' medical records. Conditional logistic regressions were then conducted to explore potential exposures associated with SCD.</p> </sec> <sec id="acer12820-sec-0003" sec-type="section"> <title>Results</title> <p>The sample had substantially higher SCD mortality (SMR 12.8) compared to the general population. After adjustments in the multivariate analyses for the clinical profiles at the index (earliest) admission, both abnormal electrocardiography (ECG) (adjusted risk ratio = 16.97, 95% confidence interval (CI) 1.60 to 179.58, <italic>p</italic> = 0.019) and elevated aspartate aminotransferase levels (adjusted risk ratio = 1.01, 95% CI 1.00 to 1.02, <italic>p</italic> = 0.046) were significantly associated with SCD.</p> </sec> <sec id="acer12820-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This study raises the question of whether intensive follow‐up of patients with elevated AST and abnormal ECG findings should be evaluated as a strategy to prevent SCD in patients with alcohol dependence.</p> </sec> </abstract>