CHICAGO — Moderate drinkers who quit after an MI have worse long-term outcomes than do those who continue light to moderate drinking, Dr. John H. Lee reported at the annual meeting of the American College of Cardiology.
“This is the first study to show that moderate drinkers who continue to drink have better outcomes than moderate drinkers who quit. This finding is especially important since many who drink may quit drinking after an MI, believing it is a behavior in their best interest for health. Since continued moderate drinkers had better outcomes, it may be prudent to recommend continued moderate drinking rather than cessation,” according to Dr. Lee of the Mid-America Heart Institute, Kansas City, Mo.
He presented a secondary analysis of data from the multicenter, double-blind, prospective Prevention of MI Early Remodeling (PREMIER) study, a placebo-controlled trial that failed to show benefit for a matrix metalloproteinase inhibitor. Of 2,498 participants, 362 were categorized as moderate, nonbinge drinkers prior to their MI. Afterward, 18% of the moderate drinkers quit drinking.
In a multivariate regression analysis adjusted for baseline health status and demographic variables, continued moderate drinkers were 24% less likely to experience all-cause mortality, rehospitalization, and/or angina during the first year post MI than moderate drinkers who quit. They were also 36% less likely to have angina 1 year post MI and scored significantly better on the physical component summary scale of the Short Form-12 quality of life measure.
A possible study confounder is the potential for the “sick quitter” syndrome, in which patients might have quit drinking post MI because their health was deteriorating to a greater extent. But this is an unlikely explanation, in Dr. Lee's view, since the association with worse outcomes stood up even though the multivariate analysis adjusted for renal failure, heart failure, diabetes, and other chronic diseases.