Heavy alcohol consumption but not smoking predicts mortality in patients with acute coronary syndrome

Allan Andersen; Steven R H Beach; Willem Philibert; James A Mills; Emily Milefchik; Emma Papworth; Kelsey Dawes; Joanna Moody; Gracie Weeks; Ellyse Froehlich; Kaitlyn deBlois; Jeffrey D Long; Ferhaan Ahmad; Robert Philibert

doi:10.1080/15592294.2024.2433833

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Heavy alcohol consumption but not smoking predicts mortality in patients with acute coronary syndrome

Journal article

Open access

Peer reviewed

Heavy alcohol consumption but not smoking predicts mortality in patients with acute coronary syndrome

Allan Andersen, Steven R H Beach, Willem Philibert, James A Mills, Emily Milefchik, Emma Papworth, Kelsey Dawes, Joanna Moody, Gracie Weeks, Ellyse Froehlich, …

Epigenetics, Vol.19(1), 2433833

12/2024

DOI: 10.1080/15592294.2024.2433833

PMCID: PMC11610560

PMID: 39602337

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Abstract

The relationship of heavy alcohol consumption (HAC) and smoking to mortality in those with CHD, and mechanisms through which these effects are elicited are not clear. In order to improve our understanding, we examined the relationship of Alcohol T-Scores (ATS), an epigenetic biomarker of chronic HAC, and cg05575921 methylation, a biomarker of smoking intensity, with all-cause mortality and degree of coronary artery obstruction in a cohort of 217 subjects admitted for CHD-related acute coronary syndrome (ACS). We found that 65% of the subjects had ATS values indicative of chronic HAC. ATS values, but not cg05575921 values, were significantly associated ( < 0.02) with subsequent proband death (total of 28 deaths) with a Cox Proportional Hazards model showing a slightly larger effect of ATS levels than age on all-cause mortality survival (overall model, < 0.003). Subjects in the highest decile of ATS scores had a 2.4-fold increase in the risk for mortality as compared to those in the lowest decile. In contrast, cg05575921 methylation ( < 0.003) but not ATS scores, were significantly inversely associated with degree of obstruction. Only 2 of the 217 subjects were referred for treatment for either smoking or drinking. We conclude that HAC is an underappreciated driver of CHD-related mortality, that those with ACS who smoke are much less likely to have significant obstruction upon cardiac imaging and that substance use treatment may be underutilized in those with CHD.

Acute Coronary Syndrome - mortality

Aged

Alcohol Drinking

DNA Methylation

Epigenesis, Genetic

Female

Humans

Male

Middle Aged

Proportional Hazards Models

Smoking - adverse effects

Details

Title: Subtitle: Heavy alcohol consumption but not smoking predicts mortality in patients with acute coronary syndrome
Creators: Allan Andersen - University of Iowa
Steven R H Beach - University of Georgia
Willem Philibert - University of Iowa
James A Mills - University of Iowa
Emily Milefchik - University of Iowa
Emma Papworth - University of Iowa
Kelsey Dawes - University of Iowa
Joanna Moody - University of Iowa
Gracie Weeks - University of Iowa
Ellyse Froehlich - University of Iowa
Kaitlyn deBlois - University of Iowa
Jeffrey D Long - University of Iowa
Ferhaan Ahmad - University of Iowa
Robert Philibert - University of Iowa
Resource Type: Journal article
Publication Details: Epigenetics, Vol.19(1), 2433833
DOI: 10.1080/15592294.2024.2433833
PMID: 39602337
PMCID: PMC11610560
NLM abbreviation: Epigenetics
ISSN: 1559-2308
eISSN: 1559-2308
Publisher: TAYLOR & FRANCIS INC
Grant note: NIH: R21 AA029435
This work was supported by NIH [R21 AA029435].
Language: English
Date published: 12/2024
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Molecular Physiology and Biophysics; Psychiatry; Iowa Neuroscience Institute; Biostatistics; Cardiovascular Medicine; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
Record Identifier: 9984751760002771

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