Mortality and light to moderate alcohol consumption after myocardial infarction

Background. Although heavy alcohol consumption increases total mortality, light to moderate consumption decreases cardiovascular and all-cause mortality in apparently healthy people. Since data are sparse on the relation of light to moderate alcohol intake to mortality in patients with previous myocardial infarction, we did a prospective study of mortality in men. Methods. Of 90,150 men in the Physicians' Health Study enrolment cohort who provided information on alcohol intake and who had no history of cancer, stroke, or liver disease, 5358 had a previous myocardial infarction. We estimated alcohol consumption by food-frequency questionnaire. Findings. During a mean follow-up of 5 years, 920 men died. After adjustment for several potential confounders, moderate alcohol intake was associated with a significant decrease in total mortality (p = 0.016). Compared with men who rarely or never drank alcohol, those who drank one to four drinks per month had a relative risk for total mortality of 0.85 (95% CI 0.69-1.05); for two to four drinks per week, the relative risk was 0.72 (0.58-0.89); for one drink per day 0.79 (0.64-9.96); and for two or more drinks per day 0.84 (0.55-1.26). Interpretation. Men with previous myocardial infarction who consume small to moderate amounts of alcohol have a lower total mortality.