Alcohol Consumption and Mortality in Patients Undergoing Coronary Artery Bypass Graft (CABG)-a Register-based Cohort Study

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2016 Nov 13

PMID 27835965

Citations 2

Authors

Mads Phillip Kofoed Grabas

Steen Moller Hansen

Christian Torp-Pedersen

Henrik Boggild

Line Rosenkilde Ullits

Ulrik Deding

Berit Jamie Nielsen

Per Foge Jensen

Charlotte Overgaard

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies have shown that compared with abstinence and heavy drinking, moderate alcohol consumption is associated with a reduced risk of mortality among the general population and patients with heart failure and myocardial infarction. We examined the association between alcohol consumption and mortality in coronary artery bypass graft (CABG) patients.

Method: We studied 1,919 first-time CABG patients using data on alcohol consumption and mortality obtained from Danish national registers from March 2006 to October 2011. Alcohol consumption was divided into the following groups: abstainers (0 units/week), moderate consumers (1-14 units/week), moderate-heavy drinkers (15-21 units/week) and heavy drinkers (>21 units/week). Hazard ratios (HR) of all-cause mortality were calculated using Cox proportional hazard regression analysis.

Results: The median follow-up was 2.2 years [IQR 2.0]. There were 112 deaths, of which 96 (86 %) were classified as cardiovascular. Adjustments for age and sex showed no increased risk of all-cause mortality for the abstainers (HR 1.61, 95 % CI, 1.00-2.58) and moderate-heavy drinkers (HR 1.40, 95 % CI, 0.73-2.67) compared with moderate consumers. However, heavy drinkers had a high risk of all-cause mortality compared with moderate consumers (HR 2.44, 95 % CI, 1.47-4.04). A full adjustment showed no increase in mortality for the abstainers (HR 1.59, 95 % CI, 0.98-2.57) and moderate-heavy drinkers (HR 1.68, 95 % CI, 0.86-3.29), while heavy drinkers were associated with an increased mortality rate (HR 1.88, 95 % CI, 1.10-3.21). There was no increased risk of 30-day mortality for the abstainers (HR 0.74, 95 % CI, 0.23-2.32), moderate-heavy drinkers (HR 0.36, 95 % CI, 0.07-1.93) and heavy drinkers (HR 2.20, 95 % CI, 0.65-7.36).

Conclusion: There was no increased risk of mortality for abstainers (0 units/week) or moderate-heavy drinkers (15-21 units/week) following a CABG. Only heavy drinking (>21 units/week) were significantly associated with an increased mortality rate. These results suggest that only heavy drinking present a risk factor among CABG patients.

Citing Articles

Alcohol Consumption and Cardiovascular Health.

Krittanawong C, Isath A, Rosenson R, Khawaja M, Wang Z, Fogg S Am J Med. 2022; 135(10):1213-1230.e3.

PMID: 35580715 PMC: 9529807. DOI: 10.1016/j.amjmed.2022.04.021.

The Monitoring of Psychosocial Factors During Hospitalization Before and After Cardiac Surgery Until Discharge From Cardiac Rehabilitation: A Research Protocol.

Callus E, Pagliuca S, Bertoldo E, Fiolo V, Jackson A, Boveri S Front Psychol. 2020; 11:2202.

PMID: 33117210 PMC: 7550819. DOI: 10.3389/fpsyg.2020.02202.

References

Lund C, Moller A, Wetterslev J, Lundstrom L . Organizational factors and long-term mortality after hip fracture surgery. A cohort study of 6143 consecutive patients undergoing hip fracture surgery. PLoS One. 2014; 9(6):e99308. PMC: 4057264. DOI: 10.1371/journal.pone.0099308. View

Vester-Andersen M, Lundstrom L, Moller M, Waldau T, Rosenberg J, Moller A . Mortality and postoperative care pathways after emergency gastrointestinal surgery in 2904 patients: a population-based cohort study. Br J Anaesth. 2014; 112(5):860-70. DOI: 10.1093/bja/aet487. View

Gisbertz S, Derksen W, de Kleijn D, Vink A, Bots M, de Vries J . The effect of alcohol on atherosclerotic plaque composition and cardiovascular events in patients with arterial occlusive disease. J Vasc Surg. 2011; 54(1):123-31. DOI: 10.1016/j.jvs.2010.12.039. View

Klatsky A, Armstrong M, Friedman G . Alcohol and mortality. Ann Intern Med. 1992; 117(8):646-54. DOI: 10.7326/0003-4819-117-8-646. View

Rimm E, Klatsky A, Grobbee D, Stampfer M . Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ. 1996; 312(7033):731-6. PMC: 2350477. DOI: 10.1136/bmj.312.7033.731. View

Olesen J, Lip G, Hansen M, Hansen P, Tolstrup J, Lindhardsen J . Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ. 2011; 342:d124. PMC: 3031123. DOI: 10.1136/bmj.d124. View

Jensen V, Rasmussen A . Danish Education Registers. Scand J Public Health. 2011; 39(7 Suppl):91-4. DOI: 10.1177/1403494810394715. View

Baadsgaard M, Quitzau J . Danish registers on personal income and transfer payments. Scand J Public Health. 2011; 39(7 Suppl):103-5. DOI: 10.1177/1403494811405098. View

Pedersen C . The Danish Civil Registration System. Scand J Public Health. 2011; 39(7 Suppl):22-5. DOI: 10.1177/1403494810387965. View

10.

Lynge E, Sandegaard J, Rebolj M . The Danish National Patient Register. Scand J Public Health. 2011; 39(7 Suppl):30-3. DOI: 10.1177/1403494811401482. View

11.

Wallach Kildemoes H, Sorensen H, Hallas J . The Danish National Prescription Registry. Scand J Public Health. 2011; 39(7 Suppl):38-41. DOI: 10.1177/1403494810394717. View

12.

Kaski J, Fernandez-Berges D . Secondary prevention after acute myocardial infarction and coronary revascularisation: focus on Angiotensin converting enzyme inhibitors. Cardiovasc Drugs Ther. 2008; 22(3):185-91. DOI: 10.1007/s10557-008-6097-8. View

13.

Murray C, Lopez A . Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997; 349(9061):1269-76. DOI: 10.1016/S0140-6736(96)07493-4. View

14.

Thun M, Peto R, Lopez A, Monaco J, Henley S, Heath Jr C . Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997; 337(24):1705-14. DOI: 10.1056/NEJM199712113372401. View

15.

Maheshwari A, Dalton J, Yared J, Mascha E, Kurz A, Sessler D . The association between alcohol consumption and morbidity and mortality in patients undergoing coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2009; 24(4):580-5. DOI: 10.1053/j.jvca.2009.09.003. View

16.

Hines L, Stampfer M, Ma J, Gaziano J, Ridker P, Hankinson S . Genetic variation in alcohol dehydrogenase and the beneficial effect of moderate alcohol consumption on myocardial infarction. N Engl J Med. 2001; 344(8):549-55. DOI: 10.1056/NEJM200102223440802. View

17.

Fagrell B, de Faire U, Bondy S, Criqui M, Gaziano M, Gronbaek M . The effects of light to moderate drinking on cardiovascular diseases. J Intern Med. 1999; 246(4):331-40. DOI: 10.1046/j.1365-2796.1999.00576.x. View

18.

Mukamal K, Girotra S, Mittleman M . Alcohol consumption, atherosclerotic progression, and prognosis among patients with coronary artery bypass grafts. Am Heart J. 2006; 151(2):368-72. DOI: 10.1016/j.ahj.2005.05.017. View

19.

Stevens J, Cai J, Evenson K, Thomas R . Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol. 2002; 156(9):832-41. DOI: 10.1093/aje/kwf114. View

20.

Calle E, Thun M, Petrelli J, Rodriguez C, Heath Jr C . Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999; 341(15):1097-105. DOI: 10.1056/NEJM199910073411501. View