The Alcohol Paradox: Investigating the Impact ofAlcohol on Major Adverse Cardiovascular EventsUsing LIONS Data
 
Chieh-Ting Kuo, Hsiao-Yen Kang^* and Li-Chuan Chen
 

Purpose: This study aimed to examine the association between alcohol consumptionand the risk of major adverse cardiovascular events (MACE) among Taiwaneseadults.
Methods: This prospective cohort study was conducted in northern Taiwan,including 5,145 participants. Data were collected through questionnaires coveringsocio-economic status, medical history, medication use, and lifestyle factors. MACE,the primary endpoint, was identified using ICD-9 and ICD-10 diagnostic codes.Hazard ratios (HR) and 95% confidence intervals (CI) for each alcohol consumptioncategory were estimated using a Cox proportional hazards model, adjusted for age,body mass index (BMI), smoking status, and diabetes history.
Results: A total of 2,167 males and 2,978 females participated. Among males, thehazard ratio for MACE increased progressively with higher weekly alcoholconsumption, reaching statistical significance at a cut-off of 420g (HR=1.657,p=0.034). In light drinkers, the HR was below 1, suggesting a potential protectiveeffect, although not statistically significant. Among females, the HR for MACE alsoincreased with higher alcohol consumption, but it did not reach statisticalsignificance. In light drinkers, the HR remained above 1, indicating an increased risk,though this was not statistically significant.
Conclusion: After adjusting for age, BMI, smoking status, and diabetes history,alcohol consumption was found to be a significant risk factor for MACE, particularlyin males. A J-shaped relationship was observed in males, where weekly alcoholconsumption exceeding 420g was associated with a significantly higher risk ofMACE compared to non-drinkers. In females, while alcohol consumption appearedto increase the risk of MACE, the association did not reach statistical significance.These findings suggest that the relationship between alcohol consumption andcardiovascular risk may differ between genders, warranting further investigation tobetter understand these differential effects and inform public health strategies aimedat reducing alcohol-related cardiovascular risk.