The effect of controlled drinking in alcoholic cardiomyopathy.
Level 3 - non-randomized controlled study
Prospective non-randomized cohort study following patients over 4 years.
PubMed 11827495 · doi:10.7326/0003-4819-136-3-200202050-00007
What was done
A 4-year prospective cohort study in Barcelona, Spain, evaluated 55 alcoholic men with cardiomyopathy (consuming >=100 g/day of ethanol for >=10 years). Researchers assessed alcohol intake, nutrition, and cardiac status via sequential echocardiography and radionuclide cardiac angiography.
What was found
After 1 year, complete abstainers showed a mean increase in left ventricular ejection fraction of 0.131 (95% CI, 0.069 to 0.193), and those consuming 20 to 60 g/day of ethanol improved by 0.125 (95% CI, 0.082 to 0.168). Patients continuing >80 g/day had further deterioration. After 4 years, ejection fraction continued to improve in both abstinent and controlled drinking groups. Ten patients consuming >80 g/day died during the study.
Why it matters
These findings suggest that harm reduction through controlled moderate drinking can facilitate cardiac recovery similar to complete abstinence in patients unable to stop drinking entirely.
Limits
The study was non-randomized with self-selected drinking categories, had a small sample size (n = 55), included only men at a single center, and relied on clinical and self-reported intake assessment.
Cited by
- supports Most patients who present with alcoholic cardiomyopathy have consumed six to eight drinks per day for 20 years or more.