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.