(1) Einstein Medical Center, Philadelphia, PA, United States
(2) Jefferson Medical College, Philadelphia, PA, United States
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Multiple diverse epidemiological studies have demonstrated a protective effect of low to moderate alcohol consumption on the risk of coronary heart disease (CHD) events. Moderate alcohol consumption favourably affects lipid profile, platelet aggregation, coagulation and endothelial function, all of which mediate its protective effect on CHD. Alcohol in moderate doses also causes reduction in infarct size similar to that seen with ischemic preconditioning. The benefits of red wine over other forms of alcohol have not been proven clinically. This review discusses current evidence and mechanisms related to the effects of alcohol on coronary artery disease.
Further research is needed to establish safe upper dose limits for the protective effect of alcohol in diverse patient populations. Also, since most epidemiologic studies are over a decade old, it would be worthwhile repeating them in the era of statin therapy.