Few studies have investigated the relation between alcohol consumption, former drinking, and prognosis after an acute myocardial infarction (AMI), particularly for non-fatal outcomes.
The SHEEP study investigated the prognostic importance of drinking habits among patients surviving a first AMI.
A total of 1346 consecutive patients between 4570 years with a first non-fatal AMI underwent a standardized clinical examination and were followed for over 8 years.
The study recorded total and cardiac mortality and hospitalization for non-fatal cardiovascular disease in relation to individual alcoholic beverage consumption at the time of AMI and 5 years before inclusion, assessed by a standardized questionnaire administered during hospitalization.
267 deaths, and 145 deaths from cardiac causes were recorded during the follow-up period. After adjustment for several potential confounders, hazard ratios for total and cardiac mortality were 0.77 (0.511.15) and 0.61 (0.361.02) for those drinking >0<5 g per day, 0.77 (0.501.18) and 0.62 (0.361.07) for those drinking 520 g per day, and 0.89 (0.561.40) and 0.69 (0.381.25) for those drinking over 20 g per day. Risk of hospitalization for recurrent non-fatal AMI, stroke, or heart failure generally showed a similar pattern to that of total and cardiac mortality. Recent quitters at the time of AMI had a hazard ratio of 4.55 (2.0310.20) for total mortality. Measures of insulin sensitivity appeared to be the strongest mediators of this association.
The researchers conclude that moderate alcohol drinking might have beneficial effects on several aspects of long-term prognosis after an AMI. The findings also highlight that former drinkers should be examined separately from long-term abstainers. The potential mechanisms that underlie this association still need to be elucidated.
Source: American Heart Journal Volume 155, Issue 1, Pages 175-181 (January 2008)