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To the Editor: Dr Mukamal and colleagues¹ reported that moderate alcohol consumption reduces the risk of mortality following acute myocardial infarction. This conclusion, however, is not warranted by their data. While unadjusted mortality was significantly less among drinkers than abstainers, this difference became statistically nonsignificant after adjustment. All the adjusted hazard ratios, regardless of the volume of alcohol consumed or the type of adjustment, had 95% confidence intervals (CIs) that included 1.0.

Unadjusted comparisons of mortality between drinkers and abstainers are subject to confounding by demographic and medical risk factors.² In this study, abstainers were significantly older, and were more likely to be female, to have lower socioeconomic status, and to have chronic illnesses, including diabetes, hypertension, and angina. The authors appropriately adjusted for these differences but did not adequately address the fact that these adjustment models reduced the survival advantage of drinkers over abstainers to levels that might have . . . [Full Text of this Article]

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RELATED ARTICLE

Prior Alcohol Consumption and Mortality Following Acute Myocardial Infarction
Kenneth J. Mukamal, Malcolm Maclure, James E. Muller, Jane B. Sherwood, and Murray A. Mittleman
JAMA. 2001;285(15):1965-1970.
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