Abstinence not always the answer

A research team from Jefferson Medical College, Philadelphia has found that both moderate drinking and abstinence will improve symptoms in men with alcoholic cardiomyopathy.

The study, published in the recent issue of the Annals of Internal Medicine, was carried out on 55 men from 31 to 59 years of age with alcoholic cardiomyopathy, (alcohol-related heart failure), who had been consuming at least 100g of ethanol per day for a minimum of 10 years.

The researchers, led by Dr Emanuel Rubin, noted that "abstinence is thought to be essential to halt further deterioration of cardiac contractility in such patients."​

During the first year of the study 17 patients stopped drinking, 15 limited their alcohol consumption to 20 to 60g of ethanol per day and 16 patients continued drinking more than 80g of ethanol per day.

Men who had stopped drinking by the first year of evaluation showed a significant improvement in left ventricular function, with a mean increase in left ventricular ejection fraction of 0.131. A similar improvement was also seen among men who limited their drinking (mean increase in left ventricular fraction 0.125), the researchers reported.

However, patients who continued to consume high quantities of alcohol had further deterioration of left ventricular ejection fraction, according to the study.

Among men who abstained or who controlled their alcohol intake, injection fraction continued to improve during the 4-year study. However, of the patients who continued to abuse alcohol, 10 died during the study period.

Despite these findings, Dr Rubin and colleagues stressed that "abstinence remains the cornerstone of any alcohol treatment programme and continues to be recommended to all alcoholic patients with dilated cardiomyopathy."​