Relationship Between Alcohol Consumption And Intracranial Stenosis And Different Subtypes Of Ischemic Stroke

Objective:To explore the relationship between alcohol consumption and large-artery atherosclerotic stroke(LAA)-one of subtypes of Trail of ORG10172 in Acute Stroke Treatment(TOAST)as well as the frequency,degree,and number of intracranial vascular stenosis in male patients with first-ever ischemic stroke.Methods:Male patients,who were more than 45 years old and diagnosed with first-ever ischemic stroke,were continuously included from January 2016 to December 2018 and classified into LAA group and non-LAA group according to TOAST classification.Each patient’s drinking habit was questioned by two neurologist specialists.Drinkers were defined as those who drank at least 5days per week(>30g/d)for more than 6 months.The total patients were classified into nondrinkers and drinkers,and the latter were further divided into three subgroups according to the alcohol consumption per week(<150g/week,150-300g/week and>300g/week).Some of them were performed by digital substraction angiography to assess the intracranial vascular condition,and we only analysed those with intracranial vascular stenosis and without cerebrovascular stenosis.The variables included age,history of hypertension,history of diabetes,smoking,drinking and hyperlipemia were compared between groups by aχ~2 test.The Student t-tests and Mann-Whitney U tests were used to examine the difference of continuous and non-continuous data between groups respectively.The predictors of intracranial stenosis and LAA were studied by binary regression model.All statistical analyses were performed by using SPSS17.0 and P<0.05 was identified as significant difference.Results:A total of 571 male patients were included in this study,including 347drinkers and 224 nondrinkers.Binary regression analysis showed that drinking(P<0.001),age(OR:1.019,P=0.020),diabetes mellitus(OR:1.730,P=0.037),smoking(OR:1.870,P=0.006)and hyperlipemia(OR:2.281,P<0.001)were risk factors for LAA.The percentages of LAA in drinking subgroups were increasing as alcohol consumption increased(45.3%vs.55.6%vs.58.8%).And compared with nondrinkers,those who had less than 150g,150-300g and more than 300g alcohol consumption per week had an odds ratio of 2.204(OR:2.204,P=0.001),3.272(OR:3.272,P<0.001)and 3.867(OR:3.867,P<0.001)for LAA,respectively.We also found that drinking(P<0.001),smoking(OR:1.894,P=0.050)and hypertension(OR:2.254,P=0.007)were risk factors for intracranial vascular stenosis.Compared with nondrinkers,those who had less than 150g,150-300g and more than 300g alcohol consumption per week had an odds ratio of 2.970(OR:2.970,P=0.002),6.700(OR:6.700,P=0.001)and7.349(OR:7.349,P<0.001)for intracranial vascular stenosis,respectively.In addition,stenosed arteries were more likely to be located in anterior and posterior circulation(11.9%vs.12.5%vs.36.5%)and bilateral cerebral hemispheres(11.9%vs.16.7%vs.50.8%)with the increasing of alcohol consumption.And the number and severity of intracranial stenosed vessels in drinkers were higher with the increasing of alcohol consumption.Conclusion:Alcohol consumption was associated with large-artery atherosclerotic stroke and its occurrence was increasing as alcohol consumption increased.Alcohol consumption was also a risk factor for intracranial vascular stenosis.The number and severity of narrowed intracranial vessels were higher as the alcohol consumption increased.