Among a large number of Chinese men presenting with chest pain or EKG changes, sequential subjects undergoing cardiac angiography were evaluated for obstructive coronary artery disease (CAD) lesions according to their reported recent alcohol intake. The study population consisted of 1,476 consecutive men 36 to 84 years of age; participants were categorized as nondrinkers, light drinkers, moderate drinkers, or heavy drinkers.

Adjusted odds ratios for angiographically proved CAD for light, moderate, and heavy drinking were 1.16 (95% confidence interval 0.68 to 1.94), 1.78 (1.35 to 2.27), and 2.18 (1.46 to 3.25). Compared to non-drinking, adjusted odds ratios were 1.03 (0.54 to 1.87) for drinking 0 to 15 years, 1.61 (1.28 to 2.14) for 16 to 30 years, and 1.98 (1.23 to 3.05) for >30 years. The authors concluded that moderate-to-heavy alcohol consumption increased the risk of CAD in Chinese men. CAD risk tended to increase with an increase in frequency and duration of drinking.

This was a very select group of patients (those presenting with chest pain or EKG changes), and not typical of the Chinese population.

No information was available on drinking patterns or on previous alcohol intake. Further, a recent large population-based study from mainland China showed that consumers of alcohol were less likely to develop coronary disease, results similar to those in most Western populations. It is not possible from the present study to say that the association of alcohol intake with CAD is different between Chinese and Western populations, as the present study gives results only for a very select group of patients.

The most important outcome regarding CAD is the occurrence of clinical events (myocardial infarction, cardiac death, etc.). The detection of such events requires long-term follow-up studies to be able to judge the overall effects of alcohol drinking on CAD.

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Reference: Zhou X, Li C, Xu W, Hong X, Chen J.

Relation of alcohol consumption to angiographically proved coronary artery disease in Chinese men. Am J Cardiol 2010;106:1101�.

To read the full critique with comments from specialists, click here: http://www.bu.edu/alcohol-forum/chinese-study-suggests-that-alcohol-increases-angiographically-significant-coronary-disease/

Contributions to this critique by the International Scientific Forum on Alcohol Research were provided by the following members:

Arne Svilaas, MD, PhD
General practice and lipidology
Oslo University Hospital
Oslo, Norway

Harvey Finkel, MD Hematology/Oncology
Boston University Medical Center
Boston, MA, USA

Tedd Goldfinger, DO, FACC
Desert Cardiology of Tucson Heart Center
Dept. of Cardiology
University of Arizona School of Medicine
Tucson, Arizona, USA

Lynn Gretkowski, MD Obstetrics/Gynecology
Mountainview, CA
Stanford University
Stanford, CA, USA

Gordon Troup, MSc, DSc
School of Physics
Monash University
Victoria, Australia

David Van Velden, MD
Dept. of Pathology
Stellenbosch University
Stellenbosch, South Africa

Andrew L. Waterhouse, PhD
Marvin Sands Professor
Department of Viticulture and Enology University of California, Davis

Ian Puddey, MD
Dean, Faculty of Medicine, Dentistry & Health Sciences
University of Western Australia Nedlands, Australia

R. Curtis Ellison, MD
Section of Preventive Medicine & Epidemiology
Boston University School of Medicine Boston, MA, USA

Francesco Orlandi, MD
Dept. of Gastroenterology
Università degli Studi di Ancona
Italy

For the detailed critique of this paper by the International Scientific Forum on Alcohol Research, go to http://www.alcoholforum4profs.org and click on Recent Reports.

The specialists who are members of the Forum are happy to respond to questions from Health Editors regarding emerging research on alcohol and health and will offer an independent opinion in context with other research on the subject

Helena Conibear co Director
The International Scientific Forum on Alcohol Research
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Professor R Curtis Ellison co Director
The International Scientific Forum on Alcohol Research
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