Sean J. Hislop, David L. Gillespie, Adam J. Doyle, Neil G. Kumar, Elisa Roztocil, John P. Cullen
University of Rochester, Division of Vascular Surgery, Rochester, NY.
OBJECTIVES: Patterns of alcohol use have been associated with increased risk of cardiovascular events. Our lab has previously demonstrated the differential effect of daily-moderate vs. weekend-binge alcohol consumption on atherosclerotic plaque development in a murine model. In this study we hypothesized that patterns of alcohol use including binge drinking would be associated with an increased risk of developing symptoms in patients with a carotid stenosis by comparison of asymptomatic and symptomatic patients undergoing carotid endarterectomy.
METHODS: In this IRB approved study, patients were asked to fill out a validated questionnaire assessing their pattern of alcohol use, specifically focusing on lifetime binge and overall drinking patterns. Past medical history, social history, and current laboratory data were assessed to evaluate for confounding variables. All patients were selected for surgery based upon NASCET and ACAS criteria.
RESULTS: 47 patients (18 symptomatic, 29 asymptomatic) were included in this study. There were no statistical differences in patient demographics. Traditional risk factors for cardiovascular events were significant in univariate analysis. Lifetime number of drinks and lifetime number of binge drinking days were found more often in symptomatic patients. When compared in multivariate analysis, only total number of binge drinking days remained significant. In multivariate analysis with known cardiovascular event risk factors, binge drinking (OR=1.21 per 1,000 binge drinking days, 95% CI=1.03-1.42, p=0.022) and non-HDL cholesterol level (OR=1.31 per 10 mg/dL, CI=1.01-1.69, p= 0.040) remained significant predictors of symptoms in patients with carotid stenosis.
CONCLUSIONS: These data suggest that there may be a significant relationship between symptoms in patients with carotid artery stenosis and the pattern in which they consume alcohol that is independent of traditional risk factors for cardiovascular events.
AUTHOR DISCLOSURES: J. P. Cullen, Nothing to disclose; A. J. Doyle, Nothing to disclose; D. L. Gillespie, Nothing to disclose; S. J. Hislop, Nothing to disclose; N. G. Kumar, Nothing to disclose; E. Roztocil, Nothing to disclose.
Posted April 2012