Context Studies have found that individuals who consume 1 alcoholic drink e
very 1 to 2 days have a lower risk of a first acute myocardial infarction (
AMI) than abstainers or heavy drinkers, but the effect of prior drinking on
mortality after AMI is uncertain.
Objective To determine the effect of prior alcohol consumption on long-term
mortality among early survivors of AMI.
Design and Setting Prospective inception cohort study conducted at 45 US co
mmuni ly and tertiary care hospitals between August 1989 and September 1994
, with a median follow-up of 3.8 years.
Patients A total of 1913 adults hospitalized with AMI between 1989 and 1994
.
Main Outcome Measure All-cause mortality, compared by self-reported average
weekly consumption of beer, wine, and liquor during the year prior to AMI.
Results Of the 1913 patients, 896 (47%) abstained from alcohol, 696 (36%) c
onsumed less than 7 alcoholic drinks/wk, and 321 (17%) consumed 7 or more a
lcoholic drinks/wk. Compared with abstainers, patients who consumed less th
an 7 drinks/wk had a lower all-cause mortality rate (3.4 vs 6.3 deaths per
100 person-years; hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.
43-0.71) as did those who consumed 7 or more drinks/wk (2.4 vs 6.3 deaths p
er 100 person-years; HR, 0.38; 95% CI, 0.25-0.55; P<.001 for trend). After
adjusting for propensity to drink and other potential confounders, increasi
ng alcohol consumption remained predictive of lower mortality for less than
7 drinks/wk, with an adjusted HR of 0.79 (95% CI, 0.60-1.03), and for 7 or
more drinks/wk, with an adjusted HR of 0.68 (95% CI, 0.45 1.05; P=.01 for
trend). The association was similar for total and cardiovascular mortality,
among both men and women, and among different types of alcoholic beverages
.
Conclusion Self-reported moderate alcohol consumption in the year prior to
AMI is associated with reduced mortality following infarction.