Prior alcohol consumption and mortality following acute myocardial infarction

JAMA. 2001 Apr 18;285(15):1965-70. doi: 10.1001/jama.285.15.1965.


Context: Studies have found that individuals who consume 1 alcoholic drink every 1 to 2 days have a lower risk of a first acute myocardial infarction (AMI) than abstainers or heavy drinkers, but the effect of prior drinking on mortality after AMI is uncertain.

Objective: To determine the effect of prior alcohol consumption on long-term mortality among early survivors of AMI.

Design and setting: Prospective inception cohort study conducted at 45 US community and tertiary care hospitals between August 1989 and September 1994, with a median follow-up of 3.8 years.

Patients: A total of 1913 adults hospitalized with AMI between 1989 and 1994.

Main outcome measure: All-cause mortality, compared by self-reported average weekly consumption of beer, wine, and liquor during the year prior to AMI.

Results: Of the 1913 patients, 896 (47%) abstained from alcohol, 696 (36%) consumed less than 7 alcoholic drinks/wk, and 321 (17%) consumed 7 or more alcoholic drinks/wk. Compared with abstainers, patients who consumed less than 7 drinks/wk had a lower all-cause mortality rate (3.4 vs 6.3 deaths per 100 person-years; hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.43-0.71) as did those who consumed 7 or more drinks/wk (2.4 vs 6.3 deaths per 100 person-years; HR, 0.38; 95% CI, 0.25-0.55; P<.001 for trend). After adjusting for propensity to drink and other potential confounders, increasing alcohol consumption remained predictive of lower mortality for less than 7 drinks/wk, with an adjusted HR of 0.79 (95% CI, 0.60-1.03), and for 7 or more drinks/wk, with an adjusted HR of 0.68 (95% CI, 0.45-1.05; P =.01 for trend). The association was similar for total and cardiovascular mortality, among both men and women, and among different types of alcoholic beverages.

Conclusion: Self-reported moderate alcohol consumption in the year prior to AMI is associated with reduced mortality following infarction.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology*
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Survival Analysis
  • Survivors*