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Risk Factors for Sudden Cardiac Death Among Patients with Alcohol Dependence: A Nested Case-Control Study.
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- المؤلفون: Wu, Shu ‐ I1,2; Tsai, Shang ‐ Ying3,4; Huang, Ming ‐ Chyi3,4,5; Stewart, Robert6; Kuo, Chian ‐ Jue3,4,5; Chen, Chiao ‐ Chicy1,3,4,7
- المصدر:
Alcoholism: Clinical & Experimental Research. Sep2015, Vol. 39 Issue 9, p1797-1804. 8p.
- الموضوع:
- معلومة اضافية
- الموضوع:
- نبذة مختصرة :
Background 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. Methods Patients with alcohol dependence ( n = 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. Results 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, p = 0.019) and elevated aspartate aminotransferase levels ( adjusted risk ratio = 1.01, 95% CI 1.00 to 1.02, p = 0.046) were significantly associated with SCD. Conclusions 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. [ABSTRACT FROM AUTHOR]
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