Wine consumption and risk of cardiovascular events after myocardial infarction: Results from the GISSI-Prevenzione trial

BackgroundTo evaluate the association of wine intake with incident cardiovascular events (CVE) and total mortality after myocardial infarction (MI).MethodsWe used prospectively ascertained information among 11,248 Italian patients with recent MI enrolled in the GISSI-Prevenzione Trial. Usual wine consumption has been categorised as never/almost never, up to 0.5 L/day, and > 0.5 L/day. Multiple imputation was used for missing values at baseline and during follow-up. We assessed adjudicated cumulative incidence of major CVE during 3.5 years of follow-up and total mortality at long-term follow-up (7.3 years), respectively. Multivariate Cox proportional hazards models were fitted to estimate hazard ratios (HR) first using data at baseline and then updated using time-varying covariates.ResultsDuring 37,021 person-years of follow-up, 1168 CVE occurred. Moderate wine intake at baseline was associated with significantly reduced risk of CVE (adjusted HR 0.87; 95% CI 0.76-0.99) as compared with non-drinkers. In time-updated analyses, results were virtually the same, though they were barely statistically not significant (adjusted HR 0.88; 95% CI 0.77-1.00). Wine intake was associated with lower risk of total mortality. In time-updated adjusted analyses, patients with wine consumption up to 0.5 L/day (HR 0.83; 95% CI 0.74-0.92) and > 0.5 L/day (HR 0.77; 95% CI 0.63-0.94) had lower mortality compared with non-drinkers (P for trend = 0.0003).ConclusionsAmong patients with established heart disease, moderate consumption of wine seems to be associated with lower incidence of CVE and total mortality as compared with non drinkers.

Research Highlights► Studies assessing association of alcohol consumption with recurrent CHD or mortality in patients with established CHD had discrepant conclusions. ► Scanty data on the effects of wine consumption on risk of cardiovascular disease in Mediterranean populations are available. ► The analysis of prospectively collected data among more than 11,000 Italians enrolled in GISSI-Prevenzione shows that light to moderate intake of wine (≤ 0.5 L/day) was associated with a reduced risk of CV events. ► These findings suggest that moderate wine intake is not harmful, and may be beneficial, in post-MI who already consume alcohol.