Monday, November 15, 2010

14440 - Alcohol Intake and Outcomes Following Coronary Artery Bypass Grafting



Light to moderate alcohol consumption has been consistently associated with a lower cardiovascular risk in apparently healthy people, but its effects among patients with established coronary heart disease are less clear. 

We aimed to investigate the impact of alcohol intake on risk of cardiovascular events after coronary artery bypass grafting (CABG).

Alcohol consumption was assessed in 1221 patients (median age 68 years[60-74]) undergoing CABG using a validated food-frequency questionnaire. Participants were followed after surgery for occurrence of major cardiac and cerebrovascular events (MACCE) including death, myocardial infarction, repeat revascularization and stroke. A Cox proportional hazards regression adjusted for all relevant risk factors including blood pressure and medications was used to assess the impact of alcohol intake on outcomes. 


After a median follow-up of 3.5 years, we documented 205 (17%) MACCEs . An inverse association (P trend=0.009) between alcohol intake and occurrence of MACCEs was observed for those consuming 5-30 g/day (corresponding to ~ 2 to 3 drinks) with a multivariate-adjusted hazard ratio (HR) of 0.75 (95% confidence interval: 0.61-0.89) compared to lifetime abstainers. 

A smaller incidence rate difference between abstainers and moderate consumers was observed in patients with left ventricular dysfunction (HR: 0.92; 95% confidence interval: 0.71-1.05) and women (HR: 0.89; 95% confidence interval: 0.73-1.01). 

Patients consuming >60 g/die showed a trend towards an increased risk of late mortality (HR: 1.8; 95% confidence interval: 0.91-3.5) especially those with left ventricular dysfunction (HR: 2.1; 95% confidence interval: 1.1-4.2)

Following CABG, light to moderate alcohol consumption reduces the rate of adverse cardiovascular events especially in men. Moderate to severe alcohol intake shows a deleterious effect in patients with left ventricular dysfunction. 



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