Impact of Wine Consumption and Heart Failure | Journal Scan

Study Questions:

What is the relation between wine consumption, health status, circulating biomarkers, and clinical outcomes in an Italian population of patients with chronic heart failure (HF) enrolled in a multicenter clinical trial?

Methods:

A brief questionnaire on dietary habits was administered at baseline to 6,973 patients enrolled in the GISSI-HF trial. The relationship between wine consumption (none, occasional, 1-2 glasses per day, ≥3 glasses per day), fatal and nonfatal clinical endpoints, quality of life, symptoms of depression, and circulating biomarkers of cardiac function and inflammation were evaluated.

Results:

Mean age was 67 years, about 80% were men, 63% were New York Heart Association class II and 34% class III, mean left ventricular ejection fraction was 33%, 50% were ischemic, 94% were on angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers, and 65% on beta-blockers. Almost 56% of the patients reported drinking at least one glass of wine per day. Alcohol use was very uncommon other than for wine. At a mean 3.9-year follow-up, all-cause mortality was about 28% and HF hospitalization about 28%. After adjustment, clinical outcomes were not significantly different in the four groups. However, patients with more frequent wine consumption had a significantly better perception of health status (Kansas City Cardiomyopathy Questionnaire score, adjusted p < 0.0001), less frequent symptoms of depression (Geriatric Depression Scale scale, adjusted p = 0.01), and lower plasma levels of biomarkers of vascular inflammation (osteoprotegerin and C-terminal proendothelin-1, adjusted p < 0.0001, and pentraxin-3, p = 0.01) after adjusting for possible confounders.

Conclusions:

In a large cohort of patients with chronic HF participating in a clinical trial, moderate wine consumption is associated with a better perceived and objective health status, lower prevalence of depression, and less vascular inflammation, but does not translate into a more favorable clinical 4-year outcome.

Perspective:

Observational studies suggest that moderate and regular alcohol consumption is associated with lower risk of cardiovascular events including myocardial infarction (MI) and incident heart failure and are safe in treated hypertension and post-MI. This study within GISSI-HF demonstrated the safety and improved quality of life associated with moderate wine use in high-risk patients with well-treated HF.

Clinical Topics: Anticoagulation Management, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Hypertension

Keywords: Adrenergic beta-Antagonists, Alcohol Drinking, Alcohols, Angiotensin-Converting Enzyme Inhibitors, Biological Markers, C-Reactive Protein, Cardiomyopathies, Depression, Follow-Up Studies, Food Habits, Health Status, Heart Failure, Hospitalization, Hypertension, Inflammation, Myocardial Infarction, Osteoprotegerin, Peptide Fragments, Prevalence, Primary Prevention, Quality of Life, Serum Amyloid P-Component, Questionnaires, Wine


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