Low-to-moderate alcohol intake and health status in heart failure patients

Background: Although heart failure (HF) guidelines recommend alcohol abstinence, existing evidence indicates that alcohol may not worsen survival and no data about associations between alcohol and health status (patients' symptoms, function, and quality of life) exist. Methods and Results: Alcohol use was quantified in 420 HF outpatients. The associations between moderate alcohol intake (1 to 60 drinks/month) and health status were assessed by comparing baseline and 1-year Kansas City Cardiomyopathy Questionnaire (KCCQ) and Short Form-12 (SF-12) scores between moderate and nondrinkers. No differences in baseline KCCQ or SF-12 scores between abstainers (n = 245) and moderate drinkers (n = 175) were observed (KCCQ 60.5 ± 24 versus 61.9 ± 23.5, P =. 55; SF-12 Physical Component Score (PCS) 33.6 ± 11.2 versus 35.3 ± 10.2, P =. 14; and SF-12 Mental Component Score (MCS) 49.1 ± 11.1 versus 49.4 ± 11.4, P =. 78). Abstainers and drinkers also had similar 1-year KCCQ scores (65.8 ± 24.5 versus 69.3 ± 24.1, P =. 23), mortality (10.5% versus 11.6%, P =. 72) and HF hospitalizations (18.0% versus 15.4%, P =. 51). Multivariable analyses controlling for baseline differences also revealed similar outcomes between abstainers and drinkers - 1-year KCCQ change = 4.3 ± 1.8 versus 5.2 ± 2.5; P =. 75), mortality (OR = 1.33, 95% CI 0.67-2.64), or HF hospitalization (OR = 1.13, 95% CI 0.60-2.11). Conclusion: No relationships between moderate alcohol consumption and health status or 1-year outcomes were identified in this multicenter observational study. These data do not support the need for complete alcohol abstinence for all HF patients among those who drink in moderation.