Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy

Paolo Costa, Mario Grassi, Licia Iacoviello, Marialuisa Zedde, Simona Marcheselli, Giorgio Silvestrelli, Maria Luisa DeLodovici, Maria Sessa, Andrea Zini, Maurizio Paciaroni, Cristiano Azzini, Massimo Gamba, Massimo Del Sette, Antonella Toriello, Carlo Gandolfo, Domenico Marco Bonifati, Rossana Tassi, Anna Cavallini, Alberto Chiti, Rocco Salvatore CalabròFrancesco Grillo, Paolo Bovi, Giampaolo Tomelleri, Augusto Di Castelnuovo, Marco Ritelli, Giancarlo Agnelli, Alessandro De Vito, Nicola Pugliese, Giuseppe Martini, Corrado Lodigiani, Andrea Morotti, Loris Poli, Valeria DeGiuli, Filomena Caria, Claudio Cornali, Giovanni DeGaetano, Marina Colombi, Alessandro Padovani, Alessandro Pezzini

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. Methods We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH. Results We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32). Conclusions In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalNeurology
Volume91
Issue number3
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Cerebral Hemorrhage
Italy
Multicenter Studies
Alcohols
Odds Ratio
Confidence Intervals
Blood Vessels
Age Groups
Stroke
Pathology
Hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Alcohol intake and the risk of intracerebral hemorrhage in the elderly : The MUCH-Italy. / Costa, Paolo; Grassi, Mario; Iacoviello, Licia; Zedde, Marialuisa; Marcheselli, Simona; Silvestrelli, Giorgio; DeLodovici, Maria Luisa; Sessa, Maria; Zini, Andrea; Paciaroni, Maurizio; Azzini, Cristiano; Gamba, Massimo; Del Sette, Massimo; Toriello, Antonella; Gandolfo, Carlo; Bonifati, Domenico Marco; Tassi, Rossana; Cavallini, Anna; Chiti, Alberto; Calabrò, Rocco Salvatore; Grillo, Francesco; Bovi, Paolo; Tomelleri, Giampaolo; Di Castelnuovo, Augusto; Ritelli, Marco; Agnelli, Giancarlo; De Vito, Alessandro; Pugliese, Nicola; Martini, Giuseppe; Lodigiani, Corrado; Morotti, Andrea; Poli, Loris; DeGiuli, Valeria; Caria, Filomena; Cornali, Claudio; DeGaetano, Giovanni; Colombi, Marina; Padovani, Alessandro; Pezzini, Alessandro.

In: Neurology, Vol. 91, No. 3, 01.01.2018, p. 1-9.

Research output: Contribution to journalArticle

Costa, P, Grassi, M, Iacoviello, L, Zedde, M, Marcheselli, S, Silvestrelli, G, DeLodovici, ML, Sessa, M, Zini, A, Paciaroni, M, Azzini, C, Gamba, M, Del Sette, M, Toriello, A, Gandolfo, C, Bonifati, DM, Tassi, R, Cavallini, A, Chiti, A, Calabrò, RS, Grillo, F, Bovi, P, Tomelleri, G, Di Castelnuovo, A, Ritelli, M, Agnelli, G, De Vito, A, Pugliese, N, Martini, G, Lodigiani, C, Morotti, A, Poli, L, DeGiuli, V, Caria, F, Cornali, C, DeGaetano, G, Colombi, M, Padovani, A & Pezzini, A 2018, 'Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy', Neurology, vol. 91, no. 3, pp. 1-9. https://doi.org/10.1212/WNL.0000000000005814
Costa, Paolo ; Grassi, Mario ; Iacoviello, Licia ; Zedde, Marialuisa ; Marcheselli, Simona ; Silvestrelli, Giorgio ; DeLodovici, Maria Luisa ; Sessa, Maria ; Zini, Andrea ; Paciaroni, Maurizio ; Azzini, Cristiano ; Gamba, Massimo ; Del Sette, Massimo ; Toriello, Antonella ; Gandolfo, Carlo ; Bonifati, Domenico Marco ; Tassi, Rossana ; Cavallini, Anna ; Chiti, Alberto ; Calabrò, Rocco Salvatore ; Grillo, Francesco ; Bovi, Paolo ; Tomelleri, Giampaolo ; Di Castelnuovo, Augusto ; Ritelli, Marco ; Agnelli, Giancarlo ; De Vito, Alessandro ; Pugliese, Nicola ; Martini, Giuseppe ; Lodigiani, Corrado ; Morotti, Andrea ; Poli, Loris ; DeGiuli, Valeria ; Caria, Filomena ; Cornali, Claudio ; DeGaetano, Giovanni ; Colombi, Marina ; Padovani, Alessandro ; Pezzini, Alessandro. / Alcohol intake and the risk of intracerebral hemorrhage in the elderly : The MUCH-Italy. In: Neurology. 2018 ; Vol. 91, No. 3. pp. 1-9.
@article{9417d09747cc4698ac35421b213a3712,
title = "Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy",
abstract = "Objective To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. Methods We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH. Results We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95{\%} confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95{\%} CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95{\%} CI, 0.77-1.32). Conclusions In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.",
author = "Paolo Costa and Mario Grassi and Licia Iacoviello and Marialuisa Zedde and Simona Marcheselli and Giorgio Silvestrelli and DeLodovici, {Maria Luisa} and Maria Sessa and Andrea Zini and Maurizio Paciaroni and Cristiano Azzini and Massimo Gamba and {Del Sette}, Massimo and Antonella Toriello and Carlo Gandolfo and Bonifati, {Domenico Marco} and Rossana Tassi and Anna Cavallini and Alberto Chiti and Calabr{\`o}, {Rocco Salvatore} and Francesco Grillo and Paolo Bovi and Giampaolo Tomelleri and {Di Castelnuovo}, Augusto and Marco Ritelli and Giancarlo Agnelli and {De Vito}, Alessandro and Nicola Pugliese and Giuseppe Martini and Corrado Lodigiani and Andrea Morotti and Loris Poli and Valeria DeGiuli and Filomena Caria and Claudio Cornali and Giovanni DeGaetano and Marina Colombi and Alessandro Padovani and Alessandro Pezzini",
year = "2018",
month = "1",
day = "1",
doi = "10.1212/WNL.0000000000005814",
language = "English",
volume = "91",
pages = "1--9",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Alcohol intake and the risk of intracerebral hemorrhage in the elderly

T2 - The MUCH-Italy

AU - Costa, Paolo

AU - Grassi, Mario

AU - Iacoviello, Licia

AU - Zedde, Marialuisa

AU - Marcheselli, Simona

AU - Silvestrelli, Giorgio

AU - DeLodovici, Maria Luisa

AU - Sessa, Maria

AU - Zini, Andrea

AU - Paciaroni, Maurizio

AU - Azzini, Cristiano

AU - Gamba, Massimo

AU - Del Sette, Massimo

AU - Toriello, Antonella

AU - Gandolfo, Carlo

AU - Bonifati, Domenico Marco

AU - Tassi, Rossana

AU - Cavallini, Anna

AU - Chiti, Alberto

AU - Calabrò, Rocco Salvatore

AU - Grillo, Francesco

AU - Bovi, Paolo

AU - Tomelleri, Giampaolo

AU - Di Castelnuovo, Augusto

AU - Ritelli, Marco

AU - Agnelli, Giancarlo

AU - De Vito, Alessandro

AU - Pugliese, Nicola

AU - Martini, Giuseppe

AU - Lodigiani, Corrado

AU - Morotti, Andrea

AU - Poli, Loris

AU - DeGiuli, Valeria

AU - Caria, Filomena

AU - Cornali, Claudio

AU - DeGaetano, Giovanni

AU - Colombi, Marina

AU - Padovani, Alessandro

AU - Pezzini, Alessandro

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. Methods We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH. Results We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32). Conclusions In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

AB - Objective To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. Methods We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH. Results We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32). Conclusions In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

UR - http://www.scopus.com/inward/record.url?scp=85054014147&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054014147&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000005814

DO - 10.1212/WNL.0000000000005814

M3 - Article

AN - SCOPUS:85054014147

VL - 91

SP - 1

EP - 9

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 3

ER -