title: Alcohol consumption and outcome in stable outpatients with peripheral artery disease.
abstract: BACKGROUND
  The influence of alcohol consumption on outcome in patients with peripheral artery disease (PAD) has not been thoroughly studied.
  
  
  METHODS
  Factores de Riesgo y ENfermedad Arterial (FRENA) is an ongoing, multicenter, observational registry of consecutive stable outpatients with arterial disease. We compared the mortality rate and the incidence of subsequent ischemic events in patients with PAD, according to their alcohol habits.
  
  
  RESULTS
  As of August 2010, 1073 patients with PAD were recruited, of whom 863 (80%) had intermittent claudication (Fontaine stage II), 102 (9.5%) had rest pain (Fontaine stage III), and 108 (10%) had ischemic skin lesions (Fontaine stage IV). In all, 422 patients (39%) consumed alcohol during the study period. Over a mean follow-up of 13 months, 150 patients (14%) developed subsequent ischemic events (myocardial infarction 28, stroke 30, disabling claudication/critical limb ischemia 100), and 70 patients (6.5%) died. The incidence of subsequent events was the same in both subgroups: 11.8 events per 100 patient-years (rate ratio: 1.00; 95% confidence interval [CI], 0.72-1.41), but the mortality rate was significantly lower in alcohol consumers than in non-consumers: 2.78 vs 6.58 deaths per 100 patient-years (rate ratio: 0.42; 95% CI, 0.23-0.74; P = .002). This better outcome was consistently found in patients with Fontaine stages II and III or IV, and persisted after multivariate adjustment (relative risk: 0.49; 95% CI, 0.28-0.88).
  
  
  CONCLUSIONS
  In patients with PAD, moderate alcohol consumption was associated with lower cardiovascular mortality and overall mortality than abstention. These patients should be informed that low to moderate alcohol consumption may not be harmful to their health.
authors.affiliation: Primary Healthcare, ABS Gaudi, Barcelona, Spain.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Garcia-Diaz
authors.forename: Pablo Javier
authors.initials: PJ
authors.lastname: Marchena
authors.forename: Jesús
authors.initials: J
authors.lastname: Toril
authors.forename: Gemma
authors.initials: G
authors.lastname: Arnedo
authors.forename: Juan Francisco Sanchez
authors.initials: JF
authors.lastname: Muñoz-Torrero
authors.forename: Montserrat
authors.initials: M
authors.lastname: Yeste
authors.forename: Eduardo
authors.initials: E
authors.lastname: Aguilar
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000401:mortality; D002545:Brain Ischemia / Q000209:etiology; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D007383:Intermittent Claudication / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D007511:Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016017:Odds Ratio; D010045:Outpatients / Q000706:statistics & numerical data*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000209:etiology; D013695:Temperance / Q000706:statistics & numerical data; D013997:Time Factors