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Alcohol Consumption and Aneurysmal Subarachnoid Hemorrhage

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Abstract

Alcohol consumption may be a modifiable risk factor for rupture of intracranial aneurysms. Our aim is to evaluate the association between ruptured aneurysms and alcohol consumption, intensity, and cessation. The medical records of 4701 patients with 6411 radiographically confirmed intracranial aneurysms diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016 were reviewed. Individuals were divided into cases with ruptured aneurysms and controls with unruptured aneurysms. Univariable and multivariable logistic regression analyses were performed to determine the association between alcohol consumption and rupture of intracranial aneurysms. In multivariable analysis, current alcohol use (OR 1.36, 95% CI 1.17–1.58) was associated with rupture status compared with never drinkers, whereas former alcohol use was not significant (OR 1.23, 95% CI 0.92–1.63). In addition, the number of alcoholic beverages per day among current alcohol users (OR 1.13, 95% CI 1.04–1.23) was significantly associated with rupture status, whereas alcohol use intensity was not significant among former users (OR 1.02, 95% CI 0.94–1.11). Current alcohol use and intensity are significantly associated with intracranial aneurysm rupture. However, this increased risk does not persist in former alcohol users, emphasizing the potential importance of alcohol cessation in patients harboring unruptured aneurysms.

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References

  1. Hijdra A, van Gijn J, Nagelkerke NJ, Vermeulen M, van Crevel H. Prediction of delayed cerebral ischemia, rebleeding, and outcome after aneurysmal subarachnoid hemorrhage. Stroke. 1988;19(10):1250–6.

    Article  CAS  PubMed  Google Scholar 

  2. Hop JW, Rinkel GJ, Algra A, van Gijn J. Changes in functional outcome and quality of life in patients and caregivers after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2001;95(6):957–63. doi:10.3171/jns.2001.95.6.0957.

    Article  CAS  PubMed  Google Scholar 

  3. van Gijn J, Rinkel GJ. Subarachnoid haemorrhage: diagnosis, causes and management. Brain. 2001;124(Pt 2):249–78.

    Article  PubMed  Google Scholar 

  4. Feigin VL, Rinkel GJ, Lawes CM, Algra A, Bennett DA, van Gijn J, et al. Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke. 2005;36(12):2773–80. doi:10.1161/01.STR.0000190838.02954.e8.

    Article  PubMed  Google Scholar 

  5. Teunissen LL, Rinkel GJ, Algra A, van Gijn J. Risk factors for subarachnoid hemorrhage: a systematic review. Stroke. 1996;27(3):544–9.

    Article  CAS  PubMed  Google Scholar 

  6. Donahue RP, Abbott RD, Reed DM, Yano K. Alcohol and hemorrhagic stroke. The Honolulu Heart Program JAMA. 1986;255(17):2311–4.

    CAS  PubMed  Google Scholar 

  7. Ohkuma H, Tabata H, Suzuki S, Islam MS. Risk factors for aneurysmal subarachnoid hemorrhage in Aomori. Japan Stroke. 2003;34(1):96–100.

    Article  PubMed  Google Scholar 

  8. Anderson C, Ni Mhurchu C, Scott D, Bennett D, Jamrozik K, Hankey G, et al. Triggers of subarachnoid hemorrhage: role of physical exertion, smoking, and alcohol in the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS). Stroke. 2003;34(7):1771–6. doi:10.1161/01.STR.0000077015.90334.A7.

    Article  PubMed  Google Scholar 

  9. Yamada S, Koizumi A, Iso H, Wada Y, Watanabe Y, Date C, et al. Risk factors for fatal subarachnoid hemorrhage: the Japan Collaborative Cohort Study. Stroke. 2003;34(12):2781–7. doi:10.1161/01.STR.0000103857.13812.9A.

    Article  PubMed  Google Scholar 

  10. Qureshi AI, Suri MF, Yahia AM, Suarez JI, Guterman LR, Hopkins LN, et al. Risk factors for subarachnoid hemorrhage. Neurosurgery. 2001;49(3):607–12. discussion 12-3

    CAS  PubMed  Google Scholar 

  11. Lindekleiv H, Sandvei MS, Romundstad PR, Wilsgaard T, Njolstad I, Ingebrigtsen T, et al. Joint effect of modifiable risk factors on the risk of aneurysmal subarachnoid hemorrhage: a cohort study. Stroke. 2012;43(7):1885–9. doi:10.1161/STROKEAHA.112.651315.

    Article  PubMed  Google Scholar 

  12. Ruiz-Sandoval JL, Cantu C, Chiquete E, Leon-Jimenez C, Arauz A, Murillo-Bonilla LM, et al. Aneurysmal subarachnoid hemorrhage in a Mexican multicenter registry of cerebrovascular disease: the RENAMEVASC study. J Stroke Cerebrovasc Dis. 2009;18(1):48–55. doi:10.1016/j.jstrokecerebrovasdis.2008.09.019.

    Article  PubMed  Google Scholar 

  13. Juvela S, Hillbom M, Numminen H, Koskinen P. Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid hemorrhage. Stroke. 1993;24(5):639–46.

    Article  CAS  PubMed  Google Scholar 

  14. Kissela BM, Sauerbeck L, Woo D, Khoury J, Carrozzella J, Pancioli A, et al. Subarachnoid hemorrhage: a preventable disease with a heritable component. Stroke. 2002;33(5):1321–6.

    Article  PubMed  Google Scholar 

  15. Korja M, Silventoinen K, Laatikainen T, Jousilahti P, Salomaa V, Hernesniemi J, et al. Risk factors and their combined effects on the incidence rate of subarachnoid hemorrhage—a population-based cohort study. PLoS One. 2013;8(9):e73760. doi:10.1371/journal.pone.0073760.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Garcia-Rodriguez LA, Gaist D, Morton J, Cookson C, Gonzalez-Perez A. Antithrombotic drugs and risk of hemorrhagic stroke in the general population. Neurology. 2013;81(6):566–74. doi:10.1212/WNL.0b013e31829e6ffa.

    Article  CAS  PubMed  Google Scholar 

  17. Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med. 1988;319(5):267–73. doi:10.1056/NEJM198808043190503.

    Article  CAS  PubMed  Google Scholar 

  18. Sankai T, Iso H, Shimamoto T, Kitamura A, Naito Y, Sato S, et al. Prospective study on alcohol intake and risk of subarachnoid hemorrhage among Japanese men and women. Alcohol Clin Exp Res. 2000;24(3):386–9.

    Article  CAS  PubMed  Google Scholar 

  19. Iso H, Baba S, Mannami T, Sasaki S, Okada K, Konishi M, et al. Alcohol consumption and risk of stroke among middle-aged men: the JPHC study cohort I. Stroke. 2004;35(5):1124–9. doi:10.1161/01.STR.0000124459.33597.00.

    Article  PubMed  Google Scholar 

  20. Suh I, Jee SH, Kim HC, Nam CM, Kim IS, Appel LJ. Low serum cholesterol and haemorrhagic stroke in men: Korea Medical Insurance Corporation Study. Lancet. 2001;357(9260):922–5. doi:10.1016/S0140-6736(00)04213-6.

    Article  CAS  PubMed  Google Scholar 

  21. Longstreth WT Jr, Nelson LM, Koepsell TD, van Belle G. Cigarette smoking, alcohol use, and subarachnoid hemorrhage. Stroke. 1992;23(9):1242–9.

    Article  PubMed  Google Scholar 

  22. Ikehara S, Iso H, Yamagishi K, Kokubo Y, Saito I, Yatsuya H, et al. Alcohol consumption and risk of stroke and coronary heart disease among Japanese women: the Japan Public Health Center-based prospective study. Prev Med. 2013;57(5):505–10. doi:10.1016/j.ypmed.2013.07.003.

    Article  PubMed  Google Scholar 

  23. Gill JS, Shipley MJ, Tsementzis SA, Hornby RS, Gill SK, Hitchcock ER, et al. Alcohol consumption—a risk factor for hemorrhagic and non-hemorrhagic stroke. Am J Med. 1991;90(4):489–97.

    Article  CAS  PubMed  Google Scholar 

  24. Kubota M, Yamaura A, Ono J. Prevalence of risk factors for aneurysmal subarachnoid haemorrhage: results of a Japanese multicentre case control study for stroke. Br J Neurosurg. 2001;15(6):474–8.

    Article  CAS  PubMed  Google Scholar 

  25. Sandvei MS, Romundstad PR, Muller TB, Vatten L, Vik A. Risk factors for aneurysmal subarachnoid hemorrhage in a prospective population study: the HUNT study in Norway. Stroke. 2009;40(6):1958–62. doi:10.1161/STROKEAHA.108.539544.

    Article  PubMed  Google Scholar 

  26. Broderick JP, Viscoli CM, Brott T, Kernan WN, Brass LM, Feldmann E, et al. Major risk factors for aneurysmal subarachnoid hemorrhage in the young are modifiable. Stroke. 2003;34(6):1375–81. doi:10.1161/01.STR.0000074572.91827.F4.

    Article  PubMed  Google Scholar 

  27. Leppala JM, Paunio M, Virtamo J, Fogelholm R, Albanes D, Taylor PR, et al. Alcohol consumption and stroke incidence in male smokers. Circulation. 1999;100(11):1209–14.

    Article  CAS  PubMed  Google Scholar 

  28. Kawachi I, Colditz GA, Stampfer MJ, Willett WC, Manson JE, Rosner B, et al. Smoking cessation and decreased risk of stroke in women. JAMA. 1993;269(2):232–6.

    Article  CAS  PubMed  Google Scholar 

  29. Castro VM, Dligach D, Finan S, Yu S, Can A, Abd-El-Barr M, et al. Large-scale identification of patients with cerebral aneurysms using natural language processing. Neurology. 2017;88(2):164–8. doi:10.1212/WNL.0000000000003490.

    Article  PubMed  Google Scholar 

  30. Yao X, Zhang K, Bian J, Chen G. Alcohol consumption and risk of subarachnoid hemorrhage: a meta-analysis of 14 observational studies. Biomed Rep. 2016;5(4):428–36. doi:10.3892/br.2016.743.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Klatsky AL, Armstrong MA, Friedman GD, Sidney S. Alcohol drinking and risk of hemorrhagic stroke. Neuroepidemiology. 2002;21(3):115–22. doi:54808

    Article  PubMed  Google Scholar 

  32. Jeremy MG, Taylor MY. Bias and Efficiency Loss Due to Categorizing an Explanatory Variable. J Multivar Anal. 2002;83:248–63.

    Article  Google Scholar 

  33. Greving JP, Wermer MJ, Brown RD Jr, Morita A, Juvela S, Yonekura M, et al. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 2014;13(1):59–66. doi:10.1016/S1474-4422(13)70263-1.

    Article  PubMed  Google Scholar 

  34. Tromp G, Weinsheimer S, Ronkainen A, Kuivaniemi H. Molecular basis and genetic predisposition to intracranial aneurysm. Ann Med. 2014;46(8):597–606. doi:10.3109/07853890.2014.949299.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Qin L, Crews FT. NADPH oxidase and reactive oxygen species contribute to alcohol-induced microglial activation and neurodegeneration. J Neuroinflammation. 2012;9:5. doi:10.1186/1742-2094-9-5.

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Brooks PJ. Brain atrophy and neuronal loss in alcoholism: a role for DNA damage? Neurochem Int. 2000;37(5–6):403–12.

    Article  CAS  PubMed  Google Scholar 

  37. Reddy VD, Padmavathi P, Kavitha G, Saradamma B, Varadacharyulu N. Alcohol-induced oxidative/nitrosative stress alters brain mitochondrial membrane properties. Mol Cell Biochem. 2013;375(1–2):39–47. doi:10.1007/s11010-012-1526-1.

    CAS  PubMed  Google Scholar 

  38. Starke RM, Chalouhi N, Ali MS, Jabbour PM, Tjoumakaris SI, Gonzalez LF, et al. The role of oxidative stress in cerebral aneurysm formation and rupture. Curr Neurovasc Res. 2013;10(3):247–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Shiu C, Barbier E, Di Cello F, Choi HJ, Stins M. HIV-1 gp120 as well as alcohol affect blood-brain barrier permeability and stress fiber formation: involvement of reactive oxygen species. Alcohol Clin Exp Res. 2007;31(1):130–7. doi:10.1111/j.1530-0277.2006.00271.x.

    Article  CAS  PubMed  Google Scholar 

  40. Haorah J, Ramirez SH, Floreani N, Gorantla S, Morsey B, Persidsky Y. Mechanism of alcohol-induced oxidative stress and neuronal injury. Free Radic Biol Med. 2008;45(11):1542–50. doi:10.1016/j.freeradbiomed.2008.08.030.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Bau PF, Bau CH, Rosito GA, Manfroi WC, Fuchs FD. Alcohol consumption, cardiovascular health, and endothelial function markers. Alcohol. 2007;41(7):479–88. doi:10.1016/j.alcohol.2007.08.004.

    Article  CAS  PubMed  Google Scholar 

  42. Li SY, Gomelsky M, Duan J, Zhang Z, Gomelsky L, Zhang X, et al. Overexpression of aldehyde dehydrogenase-2 (ALDH2) transgene prevents acetaldehyde-induced cell injury in human umbilical vein endothelial cells: role of ERK and p38 mitogen-activated protein kinase. J Biol Chem. 2004;279(12):11244–52. doi:10.1074/jbc.M308011200.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA

    Anil Can, Yildirim H. Ozdemir, Sarajune Dagen & Rose Du

  2. Research Information Systems and Computing, Partners Healthcare, Boston, MA, USA

    Victor M. Castro, Vivian Gainer & Shawn Murphy

  3. Boston Children’s Hospital Informatics Program, Boston, MA, USA

    Dmitriy Dligach, Sean Finan & Guergana Savova

  4. Department of Computer Science, Loyola University, Chicago, IL, USA

    Dmitriy Dligach

  5. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Sheng Yu & Scott T. Weiss

  6. Center for Statistical Science, Tsinghua University, Beijing, China

    Sheng Yu

  7. Division of Rheumatology, Immunology, and Allergy, Brigham and Women’s Hospital, Boston, MA, USA

    Nancy A. Shadick

  8. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA

    Shawn Murphy

  9. Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Tianxi Cai

  10. Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Scott T. Weiss & Rose Du

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  1. Anil Can
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  2. Victor M. Castro
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Correspondence to Rose Du.

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This study was funded by Partners Personalized Medicine.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Can, A., Castro, V.M., Ozdemir, Y.H. et al. Alcohol Consumption and Aneurysmal Subarachnoid Hemorrhage. Transl. Stroke Res. 9, 13–19 (2018). https://doi.org/10.1007/s12975-017-0557-z

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  • DOI: https://doi.org/10.1007/s12975-017-0557-z

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