THE SIGNIFICANCE OF CORONARY DEATH FOR THE EXCESS MORTALITY IN ALCOHOL-DEPENDENT MEN

General and validated cause-specific mortality, especially regarding c oronary disease, was studied in a population-based cohort of 1049 alco hol-dependent (DSM-III-R) men, who were discharged from a detoxificati on ward. The observed and expected numbers of deaths were 140 and 23.2 , respectively (P < 0.001). The estimated risk quotient of death was 6 .0 (95% confidence interval 5.1-7.1). The concordance between revised and official causes of death was similar to 50%, but the resulting var iation of risk quotients of cause-specific deaths generally remained w ithin the statistical uncertainty. Coronary disease contributed to 19% of the total excess mortality in cases with a validated definite deat h diagnosis. The risk of coronary death tended to be augmented during the first 2 years of discharge (P = 0.05). Thus, coronary death contri buted significantly to the excess mortality in alcohol-dependent men, and an increased vulnerability for sudden coronary death seemed to per sist for a considerable time after discharge from detoxification.