Alcohol and Acute Ischemic Stroke Onset.

Dann werde ich im Urlaub nicht mehr mittags und abends je ein Gläschen, sondern nur noch abends zwei Gläschen trinken - innerhalb einer Stunde.
(02.08.2010 - P.Bottermann)

Stroke. 2010
Published online before print July 15, 2010, doi: 10.1161/STROKEAHA.110.580092

Submitted on January 28, 2010
Revised on March 19, 2010
Accepted on April 1, 2010

Alcohol and Acute Ischemic Stroke Onset. The Stroke Onset Study

Elizabeth Mostofsky MPH; Mary R. Burger MD; Gottfried Schlaug MD, PhD; Kenneth J. Mukamal MD, MPH; Wayne D. Rosamond PhD; and Murray A. Mittleman MD, DrPH*

From the Cardiovascular Epidemiology Research Unit (E.M., K.J.M., M.A.M.), Department of Medicine, Department of Neurology (G.S.), and the Division of General Medicine & Primary Care (K.J.M.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass; the Department of Epidemiology (E.M., M.A.M.), Harvard School of Public Health, Boston, Mass; Cincinnati Children's Hospital Medical Center Heart Institute (M.R.B.), Cincinnati, Ohio; and the Department of Epidemiology (W.D.R.), University of North Carolina School of Public Health, Chapel Hill, NC.

Background and Purpose—Previous research suggests that regular heavy alcohol consumption increases the risk for ischemic stroke, whereas frequent light to moderate alcohol intake may decrease the risk. However, the risk of ischemic stroke associated with transient exposure to alcohol remains unclear. In this study, we used a case–crossover approach to test the hypothesis that alcohol consumption affects the acute risk of ischemic stroke, to determine the length of time between alcohol intake and the onset of symptoms (induction time), and to examine whether the risk varies by the type of alcohol.

Methods—In this multicenter study, we interviewed 390 patients (209 men, 181 women) between January 2001 and November 2006 (median 3 days after stroke). Alcohol consumption in the hour before stroke symptoms was compared with its expected frequency based on the usual frequency of alcohol consumption over the prior year.

Results—Of the 390 patients, 248 (64%) reported alcohol consumption in the prior year, 104 within 24 hours and 14 within 1 hour of stroke onset. The relative risk of stroke in the hour after consuming alcohol was 2.3 (95% CI, 1.4 to 4.0; P=0.002). The relative risks were similar for different types of alcoholic beverages and when the sample was restricted to those who were not simultaneously exposed to other potential triggers.

Conclusions—The risk of stroke onset is transiently elevated in the hour after alcohol ingestion.

Key words: alcohol • case–crossover • cerebrovascular disorders • epidemiology • stroke