Alcohol, myocardial infarction and survival: published estimates require correction and reanalysis

Abstract

Abstract Objective: To assess the internal consistency and interpretation of estimates reported in a 30-year cohort study of alcohol consumption and cardiovascular outcomes. Design: Critical commentary with independent recalculation of odds ratios from published aggregate data. Setting: A Swedish occupational cohort study with 30 years of follow-up. Subjects: Published data for 973 male automotive workers. Main outcome measures: Myocardial infarction, stroke, all-cause mortality and survival-time estimates. Results: The published abstract attributes an odds ratio of 0.57 to myocardial infarction, whereas the reported counts yield an odds ratio of 1.41; the 0.57 estimate relates to all-cause mortality. Further concerns include survival-time terminology, numerical inconsistencies across tables and figures, competing-risk methods, multiplicity and residual confounding, including sick-quitter bias. Conclusion: The published record requires correction and reconciliation with the underlying data and statistical analyses. The findings support only exploratory associations and do not establish cardioprotection or a survival benefit from alcohol consumption.