Effects of Alcohol on Restenosis After PTCA and Stenting

Alcohol intake
can reduce the risk of coronary artery disease through various
possible mechanisms (e.g., influencing the coagulation cascade,
affecting lipids). In a retrospective cohort study, researchers
examined whether intake could lower risk of restenosis in men with
coronary artery disease treated with percutaneous transluminal
coronary angioplasty (PTCA) and stent implantation. They examined
225 men (with 346 stents among them) who underwent these procedures
and had another angiogram 6 months later. Most consumed <350
g of alcohol per week (less than approximately 3 drinks a day).

• Men who consumed
  50 g–700 g of alcohol per week, compared with those who
  drank <50 g per week, had significantly less coronary restenosis
  (34% versus 49%) and repeat angioplasty (23% versus 43%) per
  treated arterial segment. They also had a lower mean loss of
  the coronary artery luminal diameter (1.1 mm versus 1.5 mm).
• In multivariable
  analyses adjusted for various demographic, behavioral, and clinical
  factors, alcohol consumption was independently and significantly
  associated with restenosis (odds ratio, OR, 0.5), repeat angioplasty
  (OR 0.4), and loss of the luminal diameter (P=0.005).

Comments:

These results, which support previous animal and human research, strongly suggest that moderate alcohol intake protects against restenosis in patients undergoing angioplasty and stenting. Similar studies of patients undergoing angioplasty are needed to determine if alcohol’s apparent protection against restenosis remains with the implantation of drug-eluting stents (which were not used in this study).

R.
Curtis Ellison, MD

Reference:

Niroomand F, Hauer O, Tiefenbacher CP, et al. Influence of alcohol consumption on restenosis rate after percutaneous transluminal coronary angioplasty and stent implantation. Heart. 2004;90(10):1189–1193.
(view
abstract)