CLINICAL STUDIES
Light-to-moderate alcohol consumption and prognosis in patients with left ventricular systolic dysfunction
Howard A. Cooper, MD*  ,
Derek V. Exner, MD, MPH* and
Michael J. Domanski, MD, FACC*
* Clinical Trials Research Group, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
Division of Cardiology, Georgetown University Medical Center, Washington, D.C., USA
Manuscript received September 14, 1999;
revised manuscript received December 13, 1999,
accepted February 9, 2000.
Reprint requests and correspondence: Dr. Howard A. Cooper, Two Rockledge Centre, Room 8149, 6701 Rockledge Drive, MSC 7936, Bethesda, Maryland 20892
Cooperh{at}nih.gov
OBJECTIVES
The study evaluated the relationship between light-to-moderate alcohol consumption and prognosis in patients with left ventricular (LV) systolic dysfunction.
BACKGROUND
Although chronic consumption of large amounts of alcohol can lead to cardiomyopathy, the effects of light-to-moderate alcohol consumption in patients with LV dysfunction are unknown.
METHODS
The relationship between light-to-moderate alcohol consumption and prognosis was assessed in participants in the Studies of Left Ventricular Dysfunction (SOLVD), all of whom had ejection fraction values  0.35. Baseline characteristics and event rates of patients who consumed 1 to 14 drinks per week (light-to-moderate drinkers, n = 2,594) were compared with those of patients who reported no alcohol consumption (nondrinkers, n = 3,719). The association between light-to-moderate alcohol consumption and prognosis was evaluated using Cox proportional hazards analysis, controlling for baseline differences and important covariates.
RESULTS
Mortality rates were lower among light-to-moderate drinkers than among nondrinkers (7.2 vs. 9.4 deaths/100 person-years, p < 0.001). Among patients with ischemic LV dysfunction, light-to-moderate alcohol consumption was independently associated with a reduced risk of all-cause mortality (RR [relative risk] 0.85, p = 0.01), particularly for death from myocardial infarction (RR 0.55, p < 0.001). The risks of cardiovascular death, death from progressive heart failure, arrhythmic death, and hospitalization for heart failure were similar for light-to-moderate drinkers and nondrinkers in this group. Among patients with nonischemic LV dysfunction, light-to-moderate alcohol consumption had no significant effect on mortality (RR 0.93, p = 0.5).
CONCLUSIONS
Light-to-moderate alcohol consumption is not associated with an adverse prognosis in patients with LV systolic dysfunction, and it may reduce the risk of fatal myocardial infarction in patients with ischemic LV dysfunction.
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Abbreviations and Acronyms
| | CI | = confidence interval | | EF | = ejection fraction | | HDL | = high density lipoprotein | | LV | = left ventricular | | MI | = myocardial infarction | | NYHA | = New York Heart Association | | RR | = relative risk | | SOLVD | = Studies of Left Ventricular Dysfunction |
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