Effects of alcohol consumption in patients with left ventricular dysfunction

Context

This paper describes the effect on prognosis of mild to moderate alcohol consumption in patients with left ventricular dysfunction.

This research was undertaken because the effects of moderate alcohol intake on patients with left ventricular dysfunction are unclear. Previous observational studies have shown an association between moderate alcohol intake and reduction in cardiovascular mortality in the general population. The effects of high alcohol intake were not studied in this group.

Significant findings

The authors show that the consumption of up to 14 alcoholic units per week in this study population was associated with an overall 25% reduction in mortality as compared to nondrinkers (7.2 vs 9.4 deaths/100 person years). This effect appeared to be limited to subjects with ischaemic aetiology. In this group, mild to moderate alcohol consumption showed an independent association with decreased risk of all-cause mortality (relative risk 0.85), particularly in death from myocardial infarction (relative risk 0.55). In patients with a nonischaemic aetiology, mild to moderate alcohol consumption had no significant effect on mortality.

Comments

I found this article interesting because it does not suggest an adverse effect of modest alcohol consumption in patients with left ventricular dysfunction, and indeed suggests a possible benefit. This benefit appears to be limited to those with an ischaemic aetiology, predominantly through a reduction in death from myocardial infarction.

The implication of these findings is that patients with left ventricular dysfunction who consume a moderate amount of alcohol should not be actively discouraged from doing so. Such patients often enquire about the effects of alcohol on their condition and this paper goes some way towards helping physicians respond to such questions.

Methods

Patients studied were a large subgroup (6600 subjects) from the studies of left ventricular dysfunction population. Patients with alcoholic cardiomyopathy were excluded.