Evidence for a Direct Harmful Effect of Alcohol on Myocardial Health: A Large Cross‐Sectional Study of Consumption Patterns and Cardiovascular Disease Risk Biomarkers From Northwest Russia, 2015 to 2017

Abstract

Background Alcohol drinking is an increasingly recognized risk factor for cardiovascular disease. However, there are few studies of the impact of harmful and hazardous drinking on biomarkers of myocardial health. We conducted a study in Russia to investigate the impact of heavy drinking on biomarkers of cardiac damage and inflammation. Methods and Results The Know Your Heart study recruited a random sample of 2479 participants from the population of northwest Russia (general population) plus 278 patients (narcology clinic subsample) with alcohol problems. The general population sample was categorized into harmful drinkers, hazardous drinkers, nonproblem drinkers, and nondrinkers, according to self‐reported level of alcohol consumption, whereas the narcology clinic sample was treated as the separate group in the analysis. Measurements were made of the following: (1) high‐sensitivity cardiac troponin T, (2) NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), and (3) hsCRP (high‐sensitivity C‐reactive protein). The narcology clinic subsample had the most extreme drinking pattern and the highest levels of all 3 biomarkers relative to nonproblem drinkers in the general population: high‐sensitivity cardiac troponin T was elevated by 10.3% (95% CI , 3.7%–17.4%), NT ‐pro BNP by 46.7% (95% CI , 26.8%–69.8%), and hsCRP by 69.2% (95% CI , 43%–100%). In the general population sample, NT ‐pro BNP was 31.5% (95% CI , 3.4%–67.2%) higher among harmful drinkers compared with nonproblem drinkers. Overall, NT ‐pro BNP and hsCRP increased with increasing intensity of alcohol exposure (test of trend P <0.001). Conclusions These results support the hypothesis that heavy alcohol drinking has an adverse effect on cardiac structure and function that may not be driven by atherosclerosis.

Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage

“…Exploration of alcohol use as a potential explanation of biomarker differences should be a potential future research direction. 37…”

The Association of Hemoglobin A1c and Fasting Glucose Levels with hs-CRP in Adults Not Diagnosed with Diabetes from the KNHANES, 2017

“…The AHA suggests that atherosclerosis is a multifactorial disease involving factors related to high blood pressure, smoking, dyslipidemia, gender, age, inactive lifestyle [ 10 ], and binge drinking [ 11 ]. Hence, these variables were included for adjustment.…”

Use of digital technology tools to examine patient adherence to a prescription omega-3 polyunsaturated acids therapy intended to mitigate cardiovascular risk: protocol and preliminary demographic data from the DIAPAsOn prospective observational study

“…Data from the Know Your Heart survey and other investigations suggest that not all of this discrepancy is explained by blood lipids (alcohol appears to exert a notable influence) but lipids are regarded as central determinants of risk [27,28]…”

“…Rates of death from CHD have been falling in Russia in recent decades but the rate of decline has been less marked than in other European countries and age-standardized mortality rates remain markedly higher than in other nations [25, 26]. Data from the Know Your Heart survey and other investigations suggest that not all of this discrepancy is explained by blood lipids (alcohol appears to exert a notable influence) but lipids are regarded as central determinants of risk [27,28]. Additional efforts to improve the management of coronary risk are therefore warranted and a focus on patient adherence to secure maximum benefit from available therapies is one logical dimension of that response.…”