Red wine consumption, coronary calcification, and long-term clinical evolution

Abstract

Coronary artery calcification (CAC) is associated with atherosclerotic complications. However, elevated CAC may not always imply a worse prognosis. Herein, we report the clinical evolution of long-term red wine (RW) drinkers in relation to CAC. We followed 200 healthy male habitual RW drinkers and compared them to 154 abstainers for a period of 5.5 years. The initial evaluation included coronary computed tomography angiography (CTA), clinical, demographics, and laboratory data. CAC was quantified by the Agatston score. The follow-up process was conducted by telephone calls and/or hospital record review. The composite end-point of total death, acute myocardial infarction (AMI), or coronary revascularization (or major adverse cardiac event - MACE) was assessed. The RW drinkers ingested 28.9±15 g of alcohol/day for 23.4±12.3 years. They had higher high-density lipoprotein and low-density lipoprotein, but lower C-reactive protein than abstainers. Age, total cholesterol, triglycerides, glucose, and liver enzymes were similar. History of diabetes was lower among drinkers, but other risk factors were similar. However, drinkers had higher CAC than abstainers; the mean value was 131.5±362 in drinkers vs 40.5±320 in abstainers (P<0.001). The median and interquartile range were 15 (0.0–131.5) in RW drinkers and 1 (0.0–40.5) in abstainers (P=0.003). During the follow-up, MACE was significantly lower in drinkers than in abstainers, despite their higher CAC. The difference was driven mainly by AMI (0 vs 6; P<0.03). Greater CAC values in this setting did not predict worse prognosis. A possible underlying mechanism is lesion calcification, which leads to plaque stabilization and less clinical events.

The Effect of Alcohol on Cardiovascular Risk Factors: Is There New Information?

“…The history of T2D was lower among drinkers, but other risk factors were similar. During the follow-up, MACE was significantly lower in drinkers than in abstainers, despite their higher CAC [38].…”

“…RW drinkers showed significantly higher LDL-C and HDL-C levels, and significantly lower high-sensitivity CRP levels and MACE compared with abstainers. Contrary to a worse prognosis, calcification of the coronary arteries of RW drinkers might lead to plaque stabilization and fewer clinical events because of the polyphenols in RW [38].…”

“…NHANES laboratory and questionnaire data from the nine surveys between 1999 and 2016. Da Luz et al [38] Cohort study, 354 participants, follow-up of 5.5 years.…”

Coronary artery calcification and dietary intake in asymptomatic men

“…The study involved 150 white men aged between 50-70 years who lived in Veranópolis. The relationship between red wine consumption and coronary calcium was previously reported ( 19 ) and showed that wine consumption was associated with higher coronary calcium but lower event rates.…”

Mechanisms of U-Shaped Association between Alcohol Intake and the Risk of Sudden Cardiac Death

“…Alcohol's effects on these risk factors include, but are not necessarily limited to, the activation of the fibrinolytic system, lowering of platelet aggregation, and improved endothelial function [1,17]. Importantly, lowering LDL cholesterol (bad cholesterol) [18] and elevating HDL cholesterol (good cholesterol) while reducing C-reactive protein levels greatly diminish the risk of CAD [18,19]. It is thought that these effects of alcohol on blood constituents and improving the lipid profile reduce the risk of atherosclerosis by preventing plaque buildup in the coronary arteries and preventing the formation of blood clots, reducing the risk of myocardial ischemia [6,19].…”