Clinical trial NCT03133689: Alcohol Consumption and Coronary Heart Disease Onset
Official title: Alcohol Consumption and Time-to-onset for Coronary Heart Disease: An Individual Participant Data Meta-analysis
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Coronary Heart Disease
Keywords: Alcohol
Coronary heart disease
Ischemic heart disease
Cardiovascular health
Individual participant data meta-analysis
Longitudinal
Lead sponsor: University College, London
Sponsor class: OTHER
Collaborators: name: Medical Research Council
name: Alcohol Research UK
First posted: 2017-04-28
Enrollment: 35132
Sex: ALL
Minimum age (years): 32
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The participants will be drawn from birth, regional and occupational cohort studies in England, Wales, Scotland and France.

Brief summary: The primary aim of this study is to examine if long-term patterns of alcohol consumption are associated with time-to-onset for incident coronary heart disease (fatal and non-fatal), using data from multiple cohorts.

Detailed description: The relationship between alcohol consumption and coronary heart disease (CHD) remains an issue of debate. By capturing drinking trajectories over time, we may be equipped to obtain new insights into this relationship. Studies have shown that such trajectories have differential associations for intermediate traits (carotid intima-media thickness, pulse wave velocity and inflammatory markers), but no studies exist that link stability of drinking to actual CHD. The current study will employ a longitudinal cohort design to evaluate the association between long-term alcohol consumption trajectories and time-to-event for CHD. Data will be drawn from six cohorts (five British, one French). The combined participant pool comprises 64,926 individuals (58% male, individual cohort sizes ranging from 1,444 to 25,636 participants); those with a baseline history of CHD will be excluded. Repeat alcohol intake measurements across a 10-year interval will be the exposure, with participants' intake trajectory defined according to their alcohol consumption volume and its consistency over time. To account for heterogeneity across cohorts, individual participant data meta-analysis methods will be employed in determining CHD diagnosis rates and hazard ratios for the different intake trajectories, with adjustment for relevant demographic and clinical characteristics. Results from the modelling work illustrating the form and magnitude of the association between the alcohol intake categories and CHD will be presented.

This work will help further understanding of the role that alcohol intake and its stability over time play in subsequent CHD risk, and will have implications for our understanding of alcohol's relationship to cardiovascular health in the general population.

Eligibility criteria: Inclusion Criteria:

* Participated in cohort studies being investigated
* Provided alcohol intake data at least one time point
* Was included in coronary heart disease onset tracking

Exclusion Criteria:

* Left cohort study prior to completion of 10 year exposure window
* Had history of coronary heart disease before end of 10 year exposure window

Primary outcomes:
measure: Coronary Heart Disease
timeFrame: From last date of alcohol assessment until the date of hospitalisation or death due to coronary heart disease, up to 22 years depending on cohort
Secondary outcomes:
Other outcomes:
Locations:
city: London
country: United Kingdom
facility: University College London
Study officials:
affiliation: University College, London
name: D O'Neill, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Britton A, Marmot MG, Shipley MJ. How does variability in alcohol consumption over time affect the relationship with mortality and coronary heart disease? Addiction. 2010 Apr;105(4):639-45. doi: 10.1111/j.1360-0443.2009.02832.x. Epub 2010 Feb 9.
citation: Roerecke M, Rehm J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis. Addiction. 2012 Jul;107(7):1246-60. doi: 10.1111/j.1360-0443.2012.03780.x. Epub 2012 Mar 21.
citation: Marmot M, Brunner E. Cohort Profile: the Whitehall II study. Int J Epidemiol. 2005 Apr;34(2):251-6. doi: 10.1093/ije/dyh372. Epub 2004 Dec 2. No abstract available.
citation: Day N, Oakes S, Luben R, Khaw KT, Bingham S, Welch A, Wareham N. EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer. Br J Cancer. 1999 Jul;80 Suppl 1:95-103. No abstract available.
citation: Goldberg M, Leclerc A, Zins M. Cohort Profile Update: The GAZEL Cohort Study. Int J Epidemiol. 2015 Feb;44(1):77-77g. doi: 10.1093/ije/dyu224. Epub 2014 Nov 23.
citation: Wadsworth M, Kuh D, Richards M, Hardy R. Cohort Profile: The 1946 National Birth Cohort (MRC National Survey of Health and Development). Int J Epidemiol. 2006 Feb;35(1):49-54. doi: 10.1093/ije/dyi201. Epub 2005 Oct 4. No abstract available.
citation: Benzeval M, Der G, Ellaway A, Hunt K, Sweeting H, West P, Macintyre S. Cohort profile: west of Scotland twenty-07 study: health in the community. Int J Epidemiol. 2009 Oct;38(5):1215-23. doi: 10.1093/ije/dyn213. Epub 2008 Oct 17. No abstract available.
citation: O'Neill D, Britton A, Hannah MK, Goldberg M, Kuh D, Khaw KT, Bell S. Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data. BMC Med. 2018 Aug 22;16(1):124. doi: 10.1186/s12916-018-1123-6.