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Updated: Jan 11, 2026
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Binge drinking and mortality after acute myocardial infarction
Kenneth J Mukamal1, Malcolm Maclure, James E Muller
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. kmukamal@bidmc.harvard.edu
Background:
Moderate drinkers have a lower risk of mortality after myocardial infarction (MI). Although binge drinking has been associated with a higher risk of MI in some studies, its relation to prognosis after MI is uncertain.
Methods And Results:
In a prospective, inception cohort study conducted at 45 US hospitals, 1935 patients hospitalized with a confirmed MI between 1989 and 1994 underwent detailed personal interviews. Patients reported their usual frequency of binge drinking of beer, wine, and liquor, defined as intake of 3 or more drinks within 1 to 2 hours, and were followed up for mortality for a median of 3.8 years. Of 1919 eligible patients, 250 (94% men) reported binge drinking during the prior year, and a total of 318 patients died during follow-up. Binge drinkers had a 2-fold higher risk of mortality than drinkers who did not binge (hazard ratio, 2.0; 95% confidence interval, 1.3 to 3.0). A comparison of 192 binge drinkers and 192 other patients matched on propensity scores yielded a similar result. The association between binge drinking and total mortality tended to be similar among patients whose usual alcohol intake was light or heavier and for binge drinkers who consumed beer, wine, or liquor. Usual alcohol intake was inversely associated with mortality, but binge drinking completely attenuated this relation.
Conclusions:
Our results suggest that alcohol consumption may be linked to potential hazards among patients who survive acute MI. Although moderate intake has been associated with lower mortality, binge drinking, even among light drinkers, appears to be associated with 2-fold higher mortality.
Insights
Binge drinking after myocardial infarction (MI) significantly increases mortality risk by twofold, even for light drinkers. This contrasts with moderate drinking, which is linked to lower mortality post-MI.
Area of Science:
- Cardiology
- Public Health
- Alcohol Research
Background:
- Moderate alcohol consumption is associated with reduced mortality risk following myocardial infarction (MI).
- The impact of binge drinking on prognosis after MI remains unclear, despite some studies linking it to increased MI risk.
Purpose of the Study:
- To investigate the association between binge drinking and mortality risk in patients who have survived a myocardial infarction.
- To determine if binge drinking affects long-term outcomes differently than usual alcohol intake patterns.
Main Methods:
- A prospective inception cohort study included 1935 patients hospitalized with confirmed MI.
- Patients were interviewed about their frequency of binge drinking (≥3 drinks in 1-2 hours) and followed for mortality over a median of 3.8 years.
- Hazard ratios were calculated, comparing binge drinkers to non-binge drinkers, with propensity score matching used for further analysis.
Main Results:
- Among 1919 eligible patients, 250 reported binge drinking, and 318 died during follow-up.
- Binge drinkers exhibited a 2-fold higher risk of mortality compared to non-binge drinkers (HR, 2.0; 95% CI, 1.3-3.0).
- This increased risk was consistent across different usual alcohol intake levels and types of alcohol consumed, and it attenuated the protective effect of usual moderate alcohol intake.
Conclusions:
- Alcohol consumption poses potential hazards for patients surviving acute myocardial infarction.
- Binge drinking, irrespective of overall intake level, is associated with a significantly higher mortality risk post-MI.
- These findings highlight the importance of considering drinking patterns, not just quantity, in cardiovascular health.
