Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction

David Aguilar, Hicham Skali, Lemuel A. Moyé, Eldrin F. Lewis, J. Michael Gaziano, John D. Rutherford, L. Howard Hartley, Otelio S. Randall, Edward M. Geltman, Gervasio A. Lamas, Jean L. Rouleau, Marc A. Pfeffer, Scott D. Solomon

Research output: Contribution to journalArticle

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Abstract

Objectives We assessed the influence of alcohol intake on the development of symptomatic heart failure (HF) in patients with left ventricular (LV) dysfunction after a myocardial infarction (MI). Background In contrast to protection from coronary heart disease, alcohol consumption has been linked to cardiodepressant effects and has been considered contraindicated in patients with HF. Methods The Survival And Ventricular Enlargement (SAVE) trial randomized 2,231 patients with a LV ejection fraction (EF) <40% following MI to an angiotensin-converting enzyme inhibitor or placebo. Patients were classified as nondrinkers, light-to-moderate drinkers (1 to 10 drinks/week), or heavy drinkers (>10 drinks/week) based on alcohol consumption reported at baseline. The primary outcome was hospitalization for HF or need for an open-label angiotensin-converting enzyme inhibitor. Analyses were repeated using alcohol consumption reported three months after MI. Results Nondrinkers were older and had more comorbidities than light-to-moderate and heavy drinkers. In univariate analyses, baseline light-to-moderate alcohol intake was associated with a lower incidence of HF compared with nondrinkers (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.57 to 0.87), whereas heavy drinking was not (HR 0.91; 95% CI 0.67 to 1.23). After adjustment for baseline differences, light-to-moderate baseline alcohol consumption no longer significantly influenced the development of HF (light-to-moderate drinkers HR 0.93; 95% CI 0.75 to 1.17; heavy drinkers HR 1.25; 95% CI 0.91 to 1.72). Alcohol consumption reported three months after the MI similarly did not modify the risk of adverse outcome. Conclusions In patients with LV dysfunction after an MI, light-to-moderate alcohol intake either at baseline or following MI did not alter the risk for the development of HF requiring hospitalization or an open-label angiotensin-converting enzyme inhibitor.

Original languageEnglish (US)
Pages (from-to)2015-2021
Number of pages7
JournalJournal of the American College of Cardiology
Volume43
Issue number11
DOIs
StatePublished - Jun 2 2004

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Left Ventricular Dysfunction
Alcohol Drinking
Heart Failure
Myocardial Infarction
Confidence Intervals
Alcohols
Angiotensin-Converting Enzyme Inhibitors
Hospitalization
Stroke Volume
Drinking
Coronary Disease
Comorbidity
Survival
Incidence

Keywords

  • CAD
  • cardiovascular
  • CI
  • confidence interval
  • coronary artery disease
  • CV
  • hazard ratio
  • heart failure
  • HF
  • HR
  • left ventricular
  • LV
  • MI
  • myocardial infarction
  • New York Heart Association
  • NYHA
  • SAVE
  • SOLVD
  • Survival And Ventricular Enlargement trial

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction. / Aguilar, David; Skali, Hicham; Moyé, Lemuel A.; Lewis, Eldrin F.; Gaziano, J. Michael; Rutherford, John D.; Hartley, L. Howard; Randall, Otelio S.; Geltman, Edward M.; Lamas, Gervasio A.; Rouleau, Jean L.; Pfeffer, Marc A.; Solomon, Scott D.

In: Journal of the American College of Cardiology, Vol. 43, No. 11, 02.06.2004, p. 2015-2021.

Research output: Contribution to journalArticle

Aguilar, D, Skali, H, Moyé, LA, Lewis, EF, Gaziano, JM, Rutherford, JD, Hartley, LH, Randall, OS, Geltman, EM, Lamas, GA, Rouleau, JL, Pfeffer, MA & Solomon, SD 2004, 'Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction', Journal of the American College of Cardiology, vol. 43, no. 11, pp. 2015-2021. https://doi.org/10.1016/j.jacc.2004.01.042
Aguilar, David ; Skali, Hicham ; Moyé, Lemuel A. ; Lewis, Eldrin F. ; Gaziano, J. Michael ; Rutherford, John D. ; Hartley, L. Howard ; Randall, Otelio S. ; Geltman, Edward M. ; Lamas, Gervasio A. ; Rouleau, Jean L. ; Pfeffer, Marc A. ; Solomon, Scott D. / Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction. In: Journal of the American College of Cardiology. 2004 ; Vol. 43, No. 11. pp. 2015-2021.
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abstract = "Objectives We assessed the influence of alcohol intake on the development of symptomatic heart failure (HF) in patients with left ventricular (LV) dysfunction after a myocardial infarction (MI). Background In contrast to protection from coronary heart disease, alcohol consumption has been linked to cardiodepressant effects and has been considered contraindicated in patients with HF. Methods The Survival And Ventricular Enlargement (SAVE) trial randomized 2,231 patients with a LV ejection fraction (EF) <40{\%} following MI to an angiotensin-converting enzyme inhibitor or placebo. Patients were classified as nondrinkers, light-to-moderate drinkers (1 to 10 drinks/week), or heavy drinkers (>10 drinks/week) based on alcohol consumption reported at baseline. The primary outcome was hospitalization for HF or need for an open-label angiotensin-converting enzyme inhibitor. Analyses were repeated using alcohol consumption reported three months after MI. Results Nondrinkers were older and had more comorbidities than light-to-moderate and heavy drinkers. In univariate analyses, baseline light-to-moderate alcohol intake was associated with a lower incidence of HF compared with nondrinkers (hazard ratio [HR] 0.71; 95{\%} confidence interval [CI] 0.57 to 0.87), whereas heavy drinking was not (HR 0.91; 95{\%} CI 0.67 to 1.23). After adjustment for baseline differences, light-to-moderate baseline alcohol consumption no longer significantly influenced the development of HF (light-to-moderate drinkers HR 0.93; 95{\%} CI 0.75 to 1.17; heavy drinkers HR 1.25; 95{\%} CI 0.91 to 1.72). Alcohol consumption reported three months after the MI similarly did not modify the risk of adverse outcome. Conclusions In patients with LV dysfunction after an MI, light-to-moderate alcohol intake either at baseline or following MI did not alter the risk for the development of HF requiring hospitalization or an open-label angiotensin-converting enzyme inhibitor.",
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T1 - Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction

AU - Aguilar, David

AU - Skali, Hicham

AU - Moyé, Lemuel A.

AU - Lewis, Eldrin F.

AU - Gaziano, J. Michael

AU - Rutherford, John D.

AU - Hartley, L. Howard

AU - Randall, Otelio S.

AU - Geltman, Edward M.

AU - Lamas, Gervasio A.

AU - Rouleau, Jean L.

AU - Pfeffer, Marc A.

AU - Solomon, Scott D.

PY - 2004/6/2

Y1 - 2004/6/2

N2 - Objectives We assessed the influence of alcohol intake on the development of symptomatic heart failure (HF) in patients with left ventricular (LV) dysfunction after a myocardial infarction (MI). Background In contrast to protection from coronary heart disease, alcohol consumption has been linked to cardiodepressant effects and has been considered contraindicated in patients with HF. Methods The Survival And Ventricular Enlargement (SAVE) trial randomized 2,231 patients with a LV ejection fraction (EF) <40% following MI to an angiotensin-converting enzyme inhibitor or placebo. Patients were classified as nondrinkers, light-to-moderate drinkers (1 to 10 drinks/week), or heavy drinkers (>10 drinks/week) based on alcohol consumption reported at baseline. The primary outcome was hospitalization for HF or need for an open-label angiotensin-converting enzyme inhibitor. Analyses were repeated using alcohol consumption reported three months after MI. Results Nondrinkers were older and had more comorbidities than light-to-moderate and heavy drinkers. In univariate analyses, baseline light-to-moderate alcohol intake was associated with a lower incidence of HF compared with nondrinkers (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.57 to 0.87), whereas heavy drinking was not (HR 0.91; 95% CI 0.67 to 1.23). After adjustment for baseline differences, light-to-moderate baseline alcohol consumption no longer significantly influenced the development of HF (light-to-moderate drinkers HR 0.93; 95% CI 0.75 to 1.17; heavy drinkers HR 1.25; 95% CI 0.91 to 1.72). Alcohol consumption reported three months after the MI similarly did not modify the risk of adverse outcome. Conclusions In patients with LV dysfunction after an MI, light-to-moderate alcohol intake either at baseline or following MI did not alter the risk for the development of HF requiring hospitalization or an open-label angiotensin-converting enzyme inhibitor.

AB - Objectives We assessed the influence of alcohol intake on the development of symptomatic heart failure (HF) in patients with left ventricular (LV) dysfunction after a myocardial infarction (MI). Background In contrast to protection from coronary heart disease, alcohol consumption has been linked to cardiodepressant effects and has been considered contraindicated in patients with HF. Methods The Survival And Ventricular Enlargement (SAVE) trial randomized 2,231 patients with a LV ejection fraction (EF) <40% following MI to an angiotensin-converting enzyme inhibitor or placebo. Patients were classified as nondrinkers, light-to-moderate drinkers (1 to 10 drinks/week), or heavy drinkers (>10 drinks/week) based on alcohol consumption reported at baseline. The primary outcome was hospitalization for HF or need for an open-label angiotensin-converting enzyme inhibitor. Analyses were repeated using alcohol consumption reported three months after MI. Results Nondrinkers were older and had more comorbidities than light-to-moderate and heavy drinkers. In univariate analyses, baseline light-to-moderate alcohol intake was associated with a lower incidence of HF compared with nondrinkers (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.57 to 0.87), whereas heavy drinking was not (HR 0.91; 95% CI 0.67 to 1.23). After adjustment for baseline differences, light-to-moderate baseline alcohol consumption no longer significantly influenced the development of HF (light-to-moderate drinkers HR 0.93; 95% CI 0.75 to 1.17; heavy drinkers HR 1.25; 95% CI 0.91 to 1.72). Alcohol consumption reported three months after the MI similarly did not modify the risk of adverse outcome. Conclusions In patients with LV dysfunction after an MI, light-to-moderate alcohol intake either at baseline or following MI did not alter the risk for the development of HF requiring hospitalization or an open-label angiotensin-converting enzyme inhibitor.

KW - CAD

KW - cardiovascular

KW - CI

KW - confidence interval

KW - coronary artery disease

KW - CV

KW - hazard ratio

KW - heart failure

KW - HF

KW - HR

KW - left ventricular

KW - LV

KW - MI

KW - myocardial infarction

KW - New York Heart Association

KW - NYHA

KW - SAVE

KW - SOLVD

KW - Survival And Ventricular Enlargement trial

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