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AHA: One or Two Drinks May Not Hurt Bypass Patients

MedpageToday

CHICAGO -- Having an alcoholic drink does not appear to cause problems for patients following coronary artery bypass graft surgery -- but doctors warn that these patients cannot have more than one or two drinks a day.

If patients consumed between 5 grams and 30 grams of alcohol a day -- the equivalents of one-to-two drinks of beer, wine, or spirits -- they reduced their risk of major acute coronary events by about 9%.

But if they drank 30 grams to 60 grams a day all the benefit vanished, and any more than that resulted in increased risk of events, said Umberto Benedetto, MD, PhD, a cardiac surgeon at University of Rome.

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  • Explain to interested patients that having an alcoholic drink (one to two drinks of beer, wine, or spirits) does not appear to cause problems for patients following coronary artery bypass graft surgery.

"Our main message from this study is that if a patient asks if he can have a drink after undergoing the surgery, we can tell him that one or two drinks are okay," he said in a press briefing during the annual scientific meeting of the American Heart Association. "We found that this level of alcohol consumption reduces cardiovascular events following coronary artery bypass graft surgery."

Benedetto said that he also found that patients who have severe pump dysfunction do not receive any benefit for alcohol consumption at any level. "Severe alcohol intake increases mortality, especially in severe pump dysfunction patients," he added.

"Most studies on drinking have shown that there is a curve effect in cardiovascular disease," said Valentin Fuster, MD, professor of medicine at Mount Sinai School of Medicine, New York. "This has been seen in several studies, including this one from Italy."

Fuster told ѻý that defining light drinking has also been a concern because what is light to moderate for one person may be far different than the same perception of that level in another individual.

"The American Heart Association defines light drinking as one alcoholic beverage a day for a woman and two such drinks for a man," he said. "At these levels, there does seem to be some protection against cardiovascular events."

"In this context," added heart surgeon and AHA spokesperson Timothy Gardner, MD, medical director of Christiana Care Health System, Newark, Del., "it would be reasonable that one or two drinks a day would not be harmful following cardiac bypass surgery."

Gardner also told ѻý that "in no way" should the results of the Italian study suggest that nondrinkers be encouraged to begin alcohol consumption.

In the study, researchers assessed alcohol consumption in 1,221 patients who were undergoing coronary artery bypass surgery; their median age was 68 years. The patients completed a food-frequency questionnaire and then were followed after surgery for occurrence of major cardiac and cerebrovascular events.

After a median follow-up of 3.5 years, the investigators documented 205 cases of major acute cardiac or cerebrovascular events. They found an inverse association (P=0.009) between alcohol intake and occurrence of these events among those patients consuming 5 to 30 g/day of alcohol.

The researchers said that after performing a multivariate analysis, they observed a 25% reduced risk of suffering a major cardiac or cerebrovascular event in these light drinkers when compared to lifetime abstainers.

Disclosures

Fuster reported financial relationships with BG Science.

Garner had no conflicts of interest

Benedetto had no conflicts of interest.

Primary Source

American Heart Association

Source Reference: Benedetto U, et al "Alcohol intake and outcomes following coronary artery bypass grafting" AHA 2010; Abstract 14440.