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Alcohol consumption and mortality in patients undergoing coronary artery bypass graft (CABG)-a register-based cohort
Mads Phillip Kofoed Grabas1, Steen Møller Hansen2, Christian Torp-Pedersen3,2
1Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg Øst, Denmark. madsgrabas@hotmail.com.
Insights
Moderate alcohol consumption may be safe for coronary artery bypass graft patients, but heavy drinking significantly increases mortality risk. This study highlights the importance of limiting alcohol intake after cardiac surgery.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Addiction Research
Background:
- Previous research indicates moderate alcohol intake is linked to lower mortality in general populations and specific cardiac conditions.
- The impact of alcohol consumption on mortality in patients undergoing coronary artery bypass graft (CABG) surgery remains less understood.
Purpose of the Study:
- To investigate the association between different levels of alcohol consumption and all-cause mortality in patients following their first CABG surgery.
Main Methods:
- A cohort of 1,919 first-time CABG patients was analyzed using Danish national registry data.
- Alcohol consumption was categorized into abstainers, moderate (1-14 units/week), moderate-heavy (15-21 units/week), and heavy (>21 units/week) drinkers.
- Cox proportional hazard regression was used to calculate hazard ratios for all-cause mortality.
Main Results:
- After full adjustment, heavy drinkers (>21 units/week) showed a significantly increased mortality rate (HR 1.88) compared to moderate consumers.
- No increased mortality risk was observed for abstainers or moderate-heavy drinkers compared to moderate consumers.
- Heavy drinking was associated with a higher risk of all-cause mortality, while 30-day mortality risk did not significantly differ across consumption groups.
Conclusions:
- Heavy alcohol consumption (>21 units/week) is a significant risk factor for increased mortality in CABG patients.
- Moderate alcohol consumption does not appear to increase mortality risk in this patient group.
- Limiting alcohol intake, particularly heavy drinking, is advisable for patients after CABG surgery.
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.
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