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(Stroke. 2000;31:1269.)
© 2000 American Heart Association, Inc.

Original Contributions

The Effect of Acute Ingestion of a Large Dose of Alcohol on the Hemostatic System and Its Circadian Variation

Heikki Numminen, MD; Martti Syrjälä, MD, PhD; Günther Benthin, PhD; Markku Kaste, MD, PhD Matti Hillbom, MD, PhD

From the Department of Neurology, Oulu University Hospital (H.N., M.H.), Oulu, Finland; and the Department of Clinical Chemistry, Helsinki University Hospital (M.S.), Department of Clinical Physiology, Karolinska Institutet at Huddinge University Hospital (G.B.). and Department of Neurology, Helsinki University Hospital (M.K.), Helsinki, Finland.

Correspondence to Prof Matti Hillbom, MD, Department of Neurology, Oulu University Hospital, FIN-90220, Oulu, Finland. E-mail matti.hillbom{at}oulu.fi

Background and Purpose—Heavy binge drinking may trigger the onset of embolic stroke and acute myocardial infarction, but the underlying mechanisms are unclear. The effects of binge drinking on the hemostatic system and its circadian variation have not been investigated. We investigated the effects of an acute intake of a large dose of alcohol (1.5 g/kg).

Methods—Twelve healthy, nonsmoking men participated in sessions where they were served ethanol in fruit juice or served fruit juice alone and, lying in a supine position, were followed up for 12 to 24 hours. The treatments were randomized and separated from each other by a 1-week washout period. Blood and urine were collected for hemostatic measurements.

Results—The urinary excretion of the platelet thromboxane A₂ metabolite 2,3-dinor-thromboxane B₂ was significantly (P<0.05) greater during the night after an evening intake of alcohol than during the control night. A smaller increase was observed during the daytime after an intake of alcohol in the morning. The effects on the endothelial prostacyclin metabolite 2,3-dinor-6-ketoprostaglandin F₁ excretion were negligible. A 7-fold increase in plasminogen activator inhibitor 1 activity was observed after both morning (P<0.05) and evening (P<0.01) intakes of alcohol.

Conclusions—This is the first study to suggest that acute ingestion of a relatively large but tolerable dose of alcohol transiently enhances thromboxane-mediated platelet activation. The observations also demonstrate alcohol-induced changes in the normal circadian periodicity of the hemostatic system in subjects not accustomed to consumption of alcohol.

Key Words: alcohol • circadian rhythm • hemostasis • prostaglandins • thrombolysis

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