Background Tobacco abuse and alcohol dependence have been established as risk factors for atherosclerotic heart disease (ASHD). Their potential synergistic effect, however, have not been previously evaluated⇓.
Objective/Purpose To investigate the synergistic role of alcohol abuse/dependence and tobacco use in the early incidence of ACS.
Methods A retrospective chart analyses of 8076 patients diagnosed with ACS between 2000 to 2014, defined by ICD-9 codes for acute MI, alcohol abuse/dependence and tobacco use. Average age of ACS was calculated for the general population. Patients were then divided into 4 subgroups based on alcohol abuse/dependence and tobacco use status as follows: non-alcoholic non-smokers, non-alcoholic smokers, alcoholic non-smokers and alcoholic smokers.
Results The mean age of our 8076 ACS patients population was ∼59.5 (95% CI 59.2–59.8). Patients with history of alcohol abuse/dependence appeared to develop ACS ∼8.7 years younger than their non-alcoholic counterparts. When tobacco use is incorporated as a risk factor, those with both alcohol abuse/dependence and tobacco use seemed to develop ACS ∼5 years earlier than those with history of either alone, and ∼20 years earlier when compared to those with neither alcohol abuse/dependence nor tobacco use.
(table 1 summarizes mean age of ACS incidence in our study subgroups).
Conclusions Alcohol abuse/dependence appears to be a risk factor for earlier ACS. In our population, the average age of ACS incidence in alcoholic patients was significantly earlier than non-alcoholic patients. Furthermore, alcoholic patients who also used tobacco developed ACS at an even younger age when compared to those who had history of either alcohol abuse/dependence or tobacco use alone, suggesting a possible synergistic effect of these two risk factors in developing early ACS. Healthcare intervention in this population through screening, counseling and education regarding alcohol abuse/dependence and smoking cession is warranted to reduce early ACS.
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