Alcohol Consumption and Risk for Venous Thromboembolism: A Meta-Analysis of Prospective Studies

Abstract

The association between alcohol consumption and venous thromboembolism (VTE) risk has been investigated by various observational studies with inconsistent results. We examined this association by performing a meta-analysis of prospective studies. A comprehensive literature search was carried out in the PubMed, EMBASE, and Web of Science from its inception to February 2020. Pooled effect estimates were calculated using a random effect model. Ten prospective studies (14 cohorts) were included in this meta-analysis with a total of 441,128 individuals and 10,221 VTE cases. Overall, the highest consumption of alcohol was not associated with the VTE risk compared with the lowest group [relative risk (RR), 0.96 (95% CI, 0.89-1.04), P = 0.293]. No obvious heterogeneity of RRs was observed across these studies (P = 0.249 for heterogeneity, I 2 = 18.8%). Egger's and Begg's tests showed no evidence of publication bias (Egger, P = 0.443; Begg, P = 0.730). In the subgroup analysis by sex, a borderline significant association between alcohol consumption and VTE risk was observed in women [RR, 0.91 (95% CI, 0.82-1.00)]. In the dose-response analysis, we observed a linear decrease in VTE risk with increasing alcohol intake (P = 0.634 for nonlinearity). However, the reduced risk was not statistically significant. In conclusion, the results from this meta-analysis suggest that alcohol intake is not related with the risk of VTE. Further large well-designed cohort studies are warranted to investigate a potential protective role of alcohol against VTE in women.

Lifestyle factors and venous thromboembolism in two cohort studies

“…Our findings showed no association of coffee consumption with VTE in women or men. With regard to alcohol consumption, our null findings in men and women were in line with a meta-analysis of around 400 thousand participants and more than 10 thousand VTE patients from 10 studies [11], which indicated that alcohol consumption was not related to the development of VTE. Likewise, there was no evidence of an association between alcohol consumption and VTE risk in a recent MR study [37].…”

“…Thus, whether smoking exerts independent effects on VTE remains undetermined. Alcohol consumption was not related to VTE in studies encompassing both women and men [11], whereas whether this association exists in women or men separately is inconclusive [11][12][13]. Data on coffee consumption [13][14][15] and diet [13,16,17] in relation to VTE are limited or conflicting.…”

“…Although physical activity as a whole was inversely associated with VTE risk, the association of daily leisure time activity with VTE might differ due to the heterogeneity in types and amount of different physical activities [9]. Sex differences have been observed in the associations of certain lifestyle factors with risk of VTE [8,11,18]. Here, we performed analyses based on two cohort studies in women and men to better define the associations of modifiable lifestyle factors, including cigarette smoking, alcohol and coffee consumption, physical activity and an index of overall diet quality, with risk of VTE and reveal possible sex differences in these associations.…”

Diet and Cardiovascular Disease: Venous Thrombo-embolism

“…Mukamal et al found that light-to-moderate alcohol intake was related to lower levels of coagulation factors, but higher consumption was related to impaired fibrinolytic potential, which implied a J-or U-shaped relationship between alcohol intake and hemostatic parameters [111]. However, Chen et al failed to find a U-shaped association [112].…”

“…Several studies have reported no association between alcohol intake and VTE [113][114][115][116]. A meta-analysis, involving almost 400 thousand participants and more than 10 thousand patients with VTE from 10 prospective studies (14 cohorts), concluded that alcohol intake was not associated with the risk of VTE overall [112]. However, some studies have suggested that alcohol may have some protective effects against VTE in women [102, 103,117].…”