Binge drinking is common in northern Europe and the United States compared with Mediterranean countries.38 In the Onset Study,20 mortality after acute myocardial infarction was twofold higher in binge drinkers than in drinkers who did not binge, both in heavy and in light drinkers, suggesting that a risk exists for episodic alcohol intake, even when the amount consumed is moderate. In PRIME, when two or three days of alcohol intake greater than 50 g were considered, the risk of developing incident hard coronary events tended to be similar to the risk associated with a single day’s heavy drinking. Episodic consumption seems at least as crucial as the volume of alcohol consumed in determining the positive association between binge drinking and the incidence of hard coronary events. The association of binge drinking with coronary heart disease mortality (cardiovascular deaths or sudden death) has been noted more often in previous studies20 21 22 23 39 than the association with cardiovascular morbidity.18
