Wine may improve spirits but not outcomes for heart failure patients

Moderate wine consumption may lighten the outlook for patients with chronic heart failure but it may not make any difference in long-term outcomes, based on results from a large Italian study.

Franco Cosmi, MD, of the cardiology department at Ospedale di Cortona in Cortona, Italy, and other researchers in the GISSI-HF study reported their results online April 29 in Circulation: Heart Failure. GISSI-HF was a double-blind randomized trial that compared n-3 polyunsaturated fatty acids with rosuvastatin in patients with symptomatic heart failure.

The study included a questionnaire about dietary habits completed by all 6,973 participants; an Italian version of the Kansas City Cardiomyopathy Questionnaire and the Geriatric Depression Scale questionnaire taken by 1,465 patients; and blood samples for biomarker testing contributed by 1,235 patients.  

Of the patients who consumed alcohol, very few drank anything except wine. In the full cohort, 35.3 percent reported that they never drank wine; 19 percent sometimes drank wine; 36.8 percent drank one to two glasses a day; and 8.9 percent drank three or more glasses a day.

At 3.9 years of follow-up, those who drank three or more glasses a day had the lowest rate for clinical outcomes (all-cause mortality, all-cause death or hospitalization for cardiovascular causes, worsening heart failure or sudden death). But the differences were no longer statistically significant after adjustments.

Those who drank one to two or three or more glasses of wine daily had the highest quality of life scores, with a median of 78.6 for the nondrinkers vs. 82.3 percent for both those who drank one to two or three or more glasses. Among those with scores of less than 50, 21 percent were nondrinkers vs. 7.4 percent of the three or more glasses group.

For the depression measure, 18.4 percent of nondrinkers reported moderate to severe depression vs. 5 percent of those who drank three glasses a day. The median score for nondrinkers and occasional drinkers was 3 vs. 2 for those who drank one to two or three or more glasses of wine.

The results for both quality of life and depression were statistically significant after adjustments.

They found that biomarkers for inflammation decreased with increasing wine consumption before and after adjustments. Cosmi et al added that the overall GISSI-HF trial found little to no prognostic value in the biomarker results, though.

“Among the various protective and risk factors which characterize [heart failure], wine does not seem to play either a beneficial nor dangerous role,” they wrote, although it did appear to affect perceived quality of life. Their findings may not apply to other cultures and populations that have different alcohol consumption habits, they added.