Alcohol's Impact on Heart Failure After MI
While patients with myocardial infarction (MI) may benefit from alcohol consumption (e.g., protection against coronary artery disease progression), they might also be more vulnerable to alcohol's cardiotoxic effects. This study aimed to assess the influence of alcohol intake on the development of symptomatic heart failure (hospitalization for heart failure or need for an angiotensin-converting enzyme inhibitor) in 2231 patients with a left ventricular ejection fraction <40% following MI. Three weeks prior to MI, 32% of these patients consumed 1–10 drinks per week while 11% consumed >10; two weeks after MI, 15% consumed 1–10 drinks per week while 1% consumed >10.
In analyses adjusted for various demographic, behavioral, and clinical factors, drinking before or after MI did not significantly affect risk of heart failure. However, despite this lack of statistical significance, hazard ratios for those consuming >10 drinks per week before MI indicated greater risk of all the cardiovascular outcomes examined (e.g., heart failure, total mortality, cardiovascular mortality).
Unlike most previous studies, this study did not find reductions in heart failure and death from moderate drinking among patients with MI and left ventricular dysfunction. However, because only 1% of those studied consumed >10 drinks per week, there were too few patients to test for either benefits or adverse consequences of drinking. The true balance of benefits and risks of alcohol use following MI remains unclear from observational studies and may be clarified only through clinical trials.R. Curtis Ellison, MD
Aguilar D, Skali H,
Moyé LA, et al. Alcohol consumption and prognosis in patients
with left ventricular systolic dysfunction after a myocardial infarction. J
Am Coll Cardiol. 2004;43(11):2015–2021.