Alcohol consumption and mortality in patients undergoing coronary artery bypass graft (CABG)-a register-based cohort study

Abstract

BackgroundPrevious studies have shown that compared with abstinence and heavy drinking, moderate alcohol consumption is associated with a reduced risk of mortality among the general population and patients with heart failure and myocardial infarction. We examined the association between alcohol consumption and mortality in coronary artery bypass graft (CABG) patients.MethodWe studied 1,919 first-time CABG patients using data on alcohol consumption and mortality obtained from Danish national registers from March 2006 to October 2011. Alcohol consumption was divided into the following groups: abstainers (0 units/week), moderate consumers (1–14 units/week), moderate-heavy drinkers (15–21 units/week) and heavy drinkers (>21 units/week). Hazard ratios (HR) of all-cause mortality were calculated using Cox proportional hazard regression analysis.ResultsThe median follow-up was 2.2 years [IQR 2.0]. There were 112 deaths, of which 96 (86 %) were classified as cardiovascular. Adjustments for age and sex showed no increased risk of all-cause mortality for the abstainers (HR 1.61, 95 % CI, 1.00–2.58) and moderate-heavy drinkers (HR 1.40, 95 % CI, 0.73–2.67) compared with moderate consumers. However, heavy drinkers had a high risk of all-cause mortality compared with moderate consumers (HR 2.44, 95 % CI, 1.47–4.04). A full adjustment showed no increase in mortality for the abstainers (HR 1.59, 95 % CI, 0.98–2.57) and moderate-heavy drinkers (HR 1.68, 95 % CI, 0.86–3.29), while heavy drinkers were associated with an increased mortality rate (HR 1.88, 95 % CI, 1.10–3.21). There was no increased risk of 30-day mortality for the abstainers (HR 0.74, 95 % CI, 0.23–2.32), moderate-heavy drinkers (HR 0.36, 95 % CI, 0.07–1.93) and heavy drinkers (HR 2.20, 95 % CI, 0.65–7.36).ConclusionThere was no increased risk of mortality for abstainers (0 units/week) or moderate-heavy drinkers (15–21 units/week) following a CABG. Only heavy drinking (>21 units/week) were significantly associated with an increased mortality rate. These results suggest that only heavy drinking present a risk factor among CABG patients.

Predictors and Outcomes of Coronary Artery Bypass Grafting: A Systematic and Untargeted Analysis of More Than 120,000 Individuals and 1,300 Disease Traits

“…Although a few drinks every now and then most likely are harmful, a previous study has shown that CABG patients who consume >21 units of alcohol per week have a 2.4-fold risk of dying compared to moderate consumers. 30 More focus should, therefore, be given to assessing excessive alcohol use pre-and postoperatively in patients undergoing CABG. The present results also highlighted the importance of risk assessment in CABG patients, as individuals in the fourth quartile of a risk score consisting of the top predictors of postoperative mortality had a 12-fold increased risk of dying compared with those in the first quartile.…”

Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization

“…Отмечается роль чрезмерного потребления алкоголя. Так, среди потребляющих ≥22 единиц в неделю риск смерти от всех причин был в 2,2 раза выше по сравнению с остальными [30].…”

The Monitoring of Psychosocial Factors During Hospitalization Before and After Cardiac Surgery Until Discharge From Cardiac Rehabilitation: A Research Protocol

“…Moderate alcohol consumption is associated with a lower risk of CHD, and an association between moderate and low morbidity and mortality among patients with recent myocardial infarction has also been found (Maclure, 1993). A study of 1,919 patients undergoing aorto-coronary bypass assessed the association between alcohol consumption and mortality, showing that heavy drinkers showed an increased risk of mortality (Grabas et al, 2016).…”

“…Studies have shown that close to two-thirds of ACS patients exhibit mild to moderate OSA. Even mild levels of OSA with minimal daytime symptoms are associated with adverse effects on endothelial function and hypertension ( Kohler et al, 2008 ; Li et al, 2017 ). In the Nakashima (2015) study, close to half of all patients were diagnosed with moderate to severe OSA, a level that has been independently associated with 2.3 times the risk of recurrent ACS events after adjusting for covariates, such as age, sex, body mass index (BMI), smoking, and diabetes.…”