Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction

Aguilar, David; Skali, Hicham; Moyé, Lemuel A.; Lewis, Eldrin F.; Gaziano, J. Michael; Rutherford, John D.; Hartley, L. Howard; Randall, Otelio S.; Geltman, Edward M.; Lamas, Gervasio A.; Rouleau, Jean L.; Pfeffer, Marc A.; Solomon, Scott D.

doi:10.1016/j.jacc.2004.01.042

Cited by 68 publications

(25 citation statements)

References 38 publications

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“…7 Older patients with HF differ from younger patients in that a higher proportion of older patients with HF have HF with preserved ejection fraction. 15 These patients are less likely to have CHD and more likely to have hypertension and atrial fibrillation. 16 A high proportion of men without a history of a doctor diagnosis of an MI in this study who developed HF did not develop an MI before developing HF (85%), which would explain the difference in findings between this and the younger US cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…11 This suggests that the lower risk of HF associated with light-to-moderate drinking may be mediated through beneficial effects of alcohol on coronary heart disease (CHD). 11 However, few studies have examined the association between alcohol drinking and risk of HF in older adults, in whom the occurrence of HF with preserved ejection fraction is more common than HF with reduced ejection fraction 15 and in whom HF is less likely to be associated with CHD. 16 Moreover, in most population-based cohort studies which have examined the association between alcohol consumption and HF risk, heavier drinking (>3 drinks/day) is underrepresented and the level of alcohol intake which is associated with increased HF risk is less certain although prospective population-based studies have suggested that the risk of developing atrial fibrillation, a major risk factor for HF, increases significantly with 5 or more drinks/ day 17 and at an even lower threshold (>3 drinks/day) in those with cardiovascular (CV) disease (CVD).…”

Section: Key Messagesmentioning

confidence: 99%

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Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study

et al. 2015

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AimsLight-to-moderate drinking has been associated with reduced risk of heart failure (HF). We have examined the association between alcohol consumption and incident HF in older British men.Methods and resultsProspective study of 3530 men aged 60–79 years with no diagnosed HF or myocardial infarction (MI) at baseline and followed up for a mean period of 11 years, in whom there were 198 incident HF cases. Men were divided into 6 categories of alcohol consumption: none, <1, 1–6, 7–13, 14–34 and ≥35 drinks/week. There was no evidence that light-to-moderate drinking is beneficial for risk of HF. Heavy drinking (≥35 drinks/week) was associated with significantly increased risk of HF. Using the large group of men drinking 1–6 drinks/week as the reference group, the relative HRs (95% confidence interval) for HF adjusted for age, lifestyle characteristics, blood pressure, atrial fibrillation and renal dysfunction were 0.97 (0.59 to 1.63), 1.39 (0.86 to 2.25), 1.00, 0.94 (0.64 to 1.43), 1.16 (0.78 to 1.71) and 1.91 (1.02 to 3.56) for the 6 alcohol groups, respectively. The increased risk associated with heavy drinking was attenuated after adjustment for N-terminal pro-brain natriuretic peptide (NT-proBNP) (HR=1.43 (0.76 to 1.69)). Stratified analysis showed heavy drinking was associated with increased HF risk only in those with ECG evidence of myocardial ischaemia.ConclusionsThere was no evidence that light-to-moderate drinking is beneficial for the prevention of HF in older men without a history of an MI. Heavier drinking (≥5 drinks/day), however, was associated with increased risk of HF in vulnerable men with underlying myocardial ischaemia.

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Section: Discussionmentioning

confidence: 99%

Section: Key Messagesmentioning

confidence: 99%

Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study

et al. 2015

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“…10 In 2231 patients from SAVE trial, with an LVEF <40% after MI, light-to-moderate alcohol intake did not alter the risk of hospitalization for HF. 8 In 449 male US physicians with HF a J-shaped relation between alcohol intake and mortality was reported, so the risk was significantly lower only in those drinking 1 to 2 glasses per day. 14 In contrast, the study on 1332 Italian subjects aged ≥65 years found that alcohol consumption was associated with a 21% lower risk of death in subjects without HF, but a 29% higher risk of death in patients with chronic HF.…”

Section: Wine Consumption and Clinical Outcomesmentioning

confidence: 99%

Regular Wine Consumption in Chronic Heart Failure

Cosmi

Giulio

Masson

et al. 2015

Circ: Heart Failure

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BACKGROUND:\ud Moderate, regular alcohol consumption is generally associated with a lower risk of cardiovascular events but data in patients with chronic heart failure are scarce. We evaluated the relations between wine consumption, health status, circulating biomarkers, and clinical outcomes in a large Italian population of patients with chronic heart failure enrolled in a multicenter clinical trial.\ud METHODS AND RESULTS:\ud A brief questionnaire on dietary habits was administered at baseline to 6973 patients enrolled in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure (GISSI-HF) trial. The relations between wine consumption, fatal and nonfatal clinical end points, quality of life, symptoms of depression, and circulating biomarkers of cardiac function and inflammation (in subsets of patients) were evaluated with simple and multivariable-adjusted statistical models. Almost 56% of the patients reported drinking at least 1 glass of wine per day. After adjustment, clinical outcomes were not significantly different in the predefined 4 groups of wine consumption. However, patients with more frequent wine consumption had a significantly better perception of health status (Kansas City Cardiomyopathy Questionnaire score, adjusted P<0.0001), less frequent symptoms of depression (Geriatric Depression Scale, adjusted P=0.01), and lower plasma levels of biomarkers of vascular inflammation (osteoprotegerin and C-terminal proendothelin-1, adjusted P<0.0001, and pentraxin-3, P=0.01) after adjusting for possible confounders.\ud CONCLUSIONS:\ud We show for the first time in a large cohort of patients with chronic heart failure that moderate wine consumption is associated with a better perceived and objective health status, lower prevalence of depression, and less vascular inflammation, but does not translate into more favorable clinical 4-year outcomes

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“…However, while alcohol drinking is inversely related to the risk of CAD-associated HF, heavy (but not light/ moderate) drinkers have a raised risk of non-CAD associated HF. 43 Further reports 44,45 argue against light drinking as a mechanism to increase the risk of HF as well.…”

Section: Nonoxidative Metabolism Of Alcohol and Myocyte Damagementioning

confidence: 99%

Alcohol Dosing and the Heart: Updating Clinical Evidence

Minno

Franchini²,

Russolillo

et al. 2011

Semin Thromb Hemost

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The consequences of heavy or irregular alcohol drinking have long been known. Recently, consistent information has been provided in support of an association between light/moderate alcohol consumption and protection from vascular and all-cause mortality, ischemic stroke, peripheral arterial disease, congestive heart failure, and recurrence of ischemic events. After reviewing the information with respect to major aspects of cardiovascular pathophysiology, to potential confounders and to underlying mechanisms, several concepts emerge. First, the recommended amounts of "safe alcohol drinking" in healthy individuals are up to two standard drinks (~20 g/d) for a man and up to one drink (10 g/d) for a nonpregnant woman. The overall balance for young premenopausal women, but not for older women, would be unfavorable for drinking. The risk of cancer would not outweigh potential benefits of alcohol on heart disease. Second, within the frame of a balanced pattern of dietary energy intake, patients with cardiovascular disease who drink alcohol should not exceed one or two standard drinks per day for women or up to two or three drinks per day for men. Third, the low rates of coronary heart disease among the Mediterranean people may be related to their pattern of drinking wine every day during meals. Regular drinking is associated with better outcomes than occasional (binge)/weekly drinking. Fourth, wine (ethanol with antioxidants) exhibits significantly higher anti-inflammatory effects than gin (ethanol without polyphenols), and thus in general wine should be preferred to liquor or beer.

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Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction

Abstract: In patients with LV dysfunction after an MI, light-to-moderate alcohol intake either at baseline or following MI did not alter the risk for the development of HF requiring hospitalization or an open-label angiotensin-converting enzyme inhibitor.

Cited by 68 publications

References 38 publications

Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study

Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study

Regular Wine Consumption in Chronic Heart Failure

Alcohol Dosing and the Heart: Updating Clinical Evidence

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