Randomized Trial Shows Patients With Diabetes and MI Benefit From Red Wine

Observational studies suggest that moderate alcohol consumption reduces myocardial infarction (MI) risk in most populations, including patients with diabetes. Clinical trial data, however, are lacking.

In this randomized trial, 131 subjects with diabetes who had recently suffered an initial MI were advised to consume a Mediterranean-type diet and either drink 4 ounces of red wine daily or abstain. At baseline and 12 months later (n=115), researchers measured cardiac function and markers of inflammation and oxidative stress (none of which differed between the groups at baseline).

• At follow-up, markers of both inflammation (i.e., C-reactive protein, tumor necrosis factor-α, interleukin-6, and interleukin-18) and oxidative stress (i.e., nitrotyrosine) were significantly lower in the intervention group than in the control group.
• Cardiac function was also better in the intervention group (i.e., lower myocardial performance index and higher transmitral Doppler flow, pulmonary venous flow, and ejection fraction).
• Changes in concentrations of nitrotyrosine, C-reactive protein, tumor necrosis factor-α, and interleukin-6 were positively related to changes in the cardiac function markers.
• Weight loss and diet did not differ between the groups.

Comments:

This study found that, over 1 year, many measures of inflammation and ventricular function in subjects with diabetes and a recent MI were better in those advised to drink red wine daily than in those advised to abstain. While this was an unblinded trial without detailed compliance data, indirect evidence (e.g., food diaries) suggests that most subjects followed the advice given. Further, weight loss and diet were not different between the groups, implying that the changes seen were likely related to wine consumption.

R. Curtis Ellison, MD

Reference:

Marfella R, Cacciapuoti F, Siniscalchi M, et al. Effect of moderate red wine intake on cardiac prognosis after recent acute myocardial infarction of subjects with Type 2 diabetes mellitus. Diabet Med. 2006;23(9):974–981.