Кросс-секционное исследование потребления алкоголя с вредными последствиями у пациентов кардиологического профиля, госпитализированных по неотложным показаниям в многопрофильный стационар

Abstract

Background. Alcohol use affects many aspects of the functioning of the cardiovascular system. It causes an increased risk of: hypertension; pathological conditions caused by disorders of generation and conduction of electrical signals in the myocardium; cardiovascular diseases such as ischaemic and haemorrhagic strokes. Aim of the study. To study the prevalence of alcohol consumption among acutely ill cardiac patients, not requiring intensive care, hospitalized in a multidisciplinary urban clinical hospital, using screening self-questionnaires (AUDIT-4) and a highly sensitive and specific marker of chronic alcohol intoxication phosphatidylethanol (PEth). Materials and Methods. Using AUDIT-4 and PEth, we studied the prevalence of alcohol use in cardiac patients with regard to their socio-demographic characteristics. Statistical analysis was performed using IBM SPSS Statistics 25.0 software. We applied descriptive statistics and logistic regression model to estimate adjusted odds ratio for socio-demographic and diagnostic cofactors associated with alcohol abuse. Study results. PEth values in peripheral blood of 0.3 µmol/l or more, indicating excessive alcohol consumption during 2-4 weeks prior to hospitalization, were noted in 8.9% of patients. At the same time, 3.0% of patients admitted the fact of alcohol consumption during the day preceding hospitalization. The presence of only one patient with a diagnosis of alcoholic cardiomyopathy is noteworthy. Negatively associated with PEth level ≥0.3 μmol/L were patients in age group ≥71 compared with patients aged 18-40 as the reference group, (AOR 0.058; CI 95% 0.009-0.379; p<0.003) and women compared with men (AOR 0.227, CI 95% 0,113-0,445; р<0,001). There was a positive association with PEth level ≥0.3 μmol/L for patients who defined their marital status as divorced/separated compared to the reference group married/married/civil partnership (AOR 2.535; CI 95% 1.218-5.276; p=0.013). A significant positive association with a PEth level ≥0.3 μmol/L (AOR 6.668; CI 95% 2.592-17.155; p<0.001) was observed in those who admitted drinking alcoholic beverages within 24 hours before hospitalization compared with the reference group who denied it. Diagnostic groups had no statistically significant associations with the outcome variable. Conclusions. Our findings support the need for brief anti-alcohol interventions by primary care physicians, especially when diagnosing alcohol-associated conditions in cardiac patients. It seems necessary to aim internists to work more carefully with diagnoses of alcohol-associated and alcohol-attributable conditions.