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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:1607.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Coronary Atherosclerosis and Alcohol Consumption

Angiographic and Mortality Data

Romana Femia; Andrea Natali; Antonio L’Abbate; Ele Ferrannini

From Department of Internal Medicine and CNR Institute of Clinical Physiology, University of Pisa School of Medicine, Pisa, Italy.

Correspondence to Ele Ferrannini, MD, Department of Internal Medicine, Via Roma, 67, 56126 Pisa, Italy. E-mail ferranni{at}ifc.cnr.it

Objective— Moderate alcohol consumption is associated with reduced cardiovascular disease (CVD) risk. Whether this protection is based on a lesser degree of coronary atherosclerosis has not been established.

Methods and Results— We studied 1676 men and 465 women consecutively undergoing coronary angiography. A score (ATS) was calculated by summing the percent lumen narrowing of all main vessels; alcohol consumption was quantitated by questionnaire. In univariate analysis, ATS was significantly (P0.001) associated with male sex, age, familial CVD, smoking, diabetes, hypertension, and serum cholesterol levels; alcohol consumption was associated with less frequent diabetes (P<0.001) and lower ATS (P=0.02). By multivariate analysis, alcohol intake was associated with lower ATS (P<0.01) independently of the other risk factors; the estimated effect size was comparable to that associated with a 1-mmol decrement in serum cholesterol. Over a median follow-up of 93 months, 37 women and 194 men died from a cardiac cause. By Cox analysis, positive predictors for cardiac mortality were male sex (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.1 to 2.6]), age (HR, 2.1; 95% CI, 1.8 to 2.5 per decade) and diabetes (HR, 1.7; 95% CI, 1.2 to 2.4), whereas alcohol consumption was the only negative predictor (HR, 0.84; 95% CI, 0.71 to 1.00).

Conclusions— In a selected high-risk population, moderate alcohol consumption was independently associated with less coronary atherosclerosis and lower risk for cardiac mortality.

In 2141 consecutive patients undergoing quantitative coronary angiography for the clinical work-up of ischemia, moderate (<231g/wk in men, <154 g/wk in women) alcohol consumption was associated with less coronary atherosclerosis and a lower risk (HR, 0.84; 95% CI, 0.71 to 1.00) of cardiac death at follow-up independently of classical cardiovascular risk factors.

Key Words: alcohol • angiography • coronary atherosclerosis

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