Alcohol Intake, Serum β2-microglobulin and Ventricular Extrasystoles

Factors related to death in five-year follow up of middle-aged men

Abstract

Common causes of death in middle-aged men in Sweden are ischemic heart disease and malignant tumours. In this work the authors relate some findings in a healthy survey of sixty-year old men to mortality in the ensuing five-year follow-up period. Of the original population of 331, 60-year old men 15 subjects (4.5%) died in the follow-up period. The factors tested for relation to death in the follow-up period were: indices of alcohol abuse, serum concentration of β₂-microglobulin and occurrence of ventricular extrasystoles in a long term (6 hrs) ambulatory electrocardiogram. It was found that in seven of the fifteen deceased subjects at least episodical heavy abuse of alcohol had prevailed. This was not evident at the health examination by use of serum gammaglutamyltransferase analysis, nor through the death certificates, but through hospital records and registration at the Temperance Board. Four subjects died (1.2%) of malignant tumours, and three of these subjects had serum-β₂-microglobulin values above the 95^th percentile in the study population. An increased risk of death, though statistically not significant, was noted in men with ventricular extrasystoles compared to those without ventricular extrasystoles in long term electrocardiogram. However, all men with ventricular extrasystoles ≥ 30/hour and those with ventricular tachycardia were alive five years later. Among the men who died due to ischemic heart disease, ventricular extrasystoles in the long-term electrocardiogram prevailed only in subjects with indices of alcohol intake. Alcohol induced fatal arrhythmias might thus be the terminating event in middle-aged men with traditional risk-factors for ischemic heart disease.