Recent heavy drinking of alcohol and embolic stroke

Background and Purpose-Epidemiological evidence suggests that heavy alcohol consumption increases the risk for ischemic stroke, whereas light-to-moder ate alcohol intake decreases the risk, but the role of different drinking p atterns has remained unclear. We investigated recent light, moderate, and h eavy alcohol drinking and former heavy drinking as risk factors for acute i schemic brain infarction by etiological subtype of stroke. Methods-We compared 212 consecutive patients aged between 16 and 60 years, who were completely evaluated for the etiology of their ischemic stroke, wi th 274 control subjects admitted to the emergency unit of the same hospital . ORs, as estimates of multivariate relative risks (RRs), and 95% CIs after adjustment for possible confounding variables were calculated by logistic regression. The ORs were adjusted for age, sex, body mass index, hypertensi on, diabetes, hyperlipemia, current smoking, and history of migraine. Results-Recent heavy drinking but not former heavy drinking was an independ ent risk factor for stroke (RR 1.82, 95% CI 1.08 to 3.05). Consumption of 1 51 to 300 g and >300 g alcohol within the week preceding the onset of strok e significantly increased the risk for cardioembolic and cryptogenic stroke . Consumption of >40 g alcohol within the preceding 24 hours increased the risk for cardiogenic embolism to the brain among those who had a high-risk source (RR 4.75, 95% CI 1.23 to 18.4), the risk for tandem embolism among t hose who had prominent large-artery atherosclerosis (RR 7.68, 95% CI 1.82 t o 32.3), and the risk for cryptogenic stroke (RR 3.84, 95% CI 1.69 to 8.71) . Light drinking did not increase the risk for stroke. Conclusions-We conclude that acute drinking of intoxicating amounts of alco hol may trigger the onset of embolic stroke among subjects who have a sourc e of thrombus in the heart or the large arteries.