Wine consumption and risk of cardiovascular events after myocardial infarction: Results from the GISSI-Prevenzione trial

Background: To evaluate the association of wine intake with incident cardiovascular events (CVE) and total mortality after myocardial infarction (MI). Methods: We used prospectively ascertained information among 11,248 Italian patients with recent MI enrolled in the GISSI-Prevenzione Trial. Usual wine consumption has been categorised as never/almost never, up to 0.5 L/day, and > 0.5 L/day. Multiple imputation was used for missing values at baseline and during follow-up. We assessed adjudicated cumulative incidence of major CVE during 3.5 years of follow-up and total mortality at long-term follow-up (7.3 years), respectively. Multivariate Cox proportional hazards models were fitted to estimate hazard ratios (HR) first using data at baseline and then updated using time-varying covariates. Results: During 37,021 person-years of follow-up, 1168 CVE occurred. Moderate wine intake at baseline was associated with significantly reduced risk of CVE (adjusted HR 0.87; 95% CI 0.76-0.99) as compared with non-drinkers. In time-updated analyses, results were virtually the same, though they were barely statistically not significant (adjusted HR 0.88; 95% CI 0.77-1.00). Wine intake was associated with lower risk of total mortality. In time-updated adjusted analyses, patients with wine consumption up to 0.5 L/day (HR 0.83; 95% CI 0.74-0.92) and > 0.5 L/day (HR 0.77; 95% CI 0.63-0.94) had lower mortality compared with non-drinkers (P for trend = 0.0003). Conclusions: Among patients with established heart disease, moderate consumption of wine seems to be associated with lower incidence of CVE and total mortality as compared with non drinkers.