Alcohol and heart attacks

Another finding for the pile: among male heart attack survivors, all source mortality risk for moderate drinkers (1-3 standard drinks per day) was 66% of the risk for non-drinkers. Here's the latest from Pai, Rimm, & Mukamal:

Moderate alcohol consumption of up to two drinks per day was significantly inversely associated with both all-cause and cardiovascular mortality in basic and adjusted models. The multivariable-adjusted HRs for total mortality were 0.78 (95% CI: 0.62–0.97) for 0.1–9.9 g/day, 0.66 (95% CI: 0.51–0.86) for 10.0–29.9 g/day, and 0.87 (95% CI: 0.61–1.25) for ≥30 g/day (P for quadratic trend = 0.006) (Table 2). Similarly, for cardiovascular mortality, the adjusted HRs were 0.74 (95% CI: 0.54–1.02) for 0.1–9.9 g/day, 0.58 (95% CI: 0.39–0.84) for 10.0–29.9 g/day, and 0.98 (95% CI: 0.60–1.60) for ≥30 g/day (P for quadratic trend = 0.003). Additional adjustments for caloric intake, omega-3 fatty acids, ST-elevation and site of initial MI, and creatinine did not appreciably attenuate the risk estimates. Although HRs were similar across alcoholic beverage types, in analyses mutually adjusted for beer, wine, and liquor, there was no significant association between specific beverage type and mortality

Ok, what if the people who were sickest after their heart attacks quit drinking and confound the measure? They also check mortality against pre-MI drinking patterns and find pretty much the same result: the adjusted hazard ratio increases from 0.66 to 0.7.

Our results clearly support the hypothesis that long-term moderate alcohol consumption among individuals with prior MI may be beneficial for all-cause and cardiovascular mortality. This U-shaped association may be stronger among men with better long-term prognosis after MI and further examination is warranted to determine the suitability of moderate alcohol consumption among individuals with other severe cardiovascular conditions.

Wonder if the doctors here note this kind of advice...