Deaths from Cardiotoxicity of Acetaldehyde

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Mon, 2016/05/23 - 20:29
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Laboratorinė medicina. 2016,
t. 18,
Nr. 1,
p. 8 -
12

Introduction. 15-30% of idiopathic atrial fibrillations are related to alcohol abuse. The pathological pathways might be oxidative stress, disorder of calcium metabolism, cardiac conduction interfer­ence as well as acetaldehyde which in­creases systemic and intra-myocardial catecholamines. Acetaldehyde acts mostly in sobering up phase.

Aim. To evaluate a risk to die in so­bering up phase when ethanol concentra­tion is higher in urine than in blood in pa­tients with ischemic heart disease.

Materials and methods. This was a single-centre retrospective study. Data of 276 cases of deaths from ischemic heart disease during a two year period were re­viewed. Cases negative for ethanol in post mortem body fluids (blood and/or urine) and cases when ethanol concentration was not measured (N=182) were excluded. Cases which conformed to criteria: ischemic heart disease as the cause of death, post mortem body fluids positive for ethanol, concentration higher in urine than in blood, were analysed further with SPSS_22.0 program.

Results. Data of 53 cases in sobering up phase were anaiysed which made the majority (56%) of cases positive for ethanol in post mortem body fluids. Ethanol con­centration in blood ranged from 0 to 3.44% with a median of 0.71. The average age of those who died in sobering up phase was 64±12 years, men being younger (61±11 years) than women (75±11). There were more men (81%) than women in the study (95% ACI [61.7; 62.3]). The average mass of a heart was 499.7±107.3 g. Deaths generally occurred when stenosis of a right coronary artery was less than 50% (95% ACI [59.7; 60.3]), whereas stenosis of a left coronary artery was mostly moderate - lower than 75% (95% ACI [17.7; 18.3]). Stenosis of a left coronary artery was clinically important (>50%) statistically significantly more of­ten (95% ACI = 60.7; 61.3).

Conclusions. A risk to die is higher in sobering up phase in patients with even mild to moderate coronary artery stenosis. A larger study is needed to de­termine populational risk.

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