Beer is an Anticoagulant!

ABSTRACT & COMMENTARY

Synopsis: Moderate beer consumption results in a decrease in thrombogenic activity in patients with coronary artery disease.

Source: Gorinstein S, et al. J Intern Med 1997;241:47-51.

Gorinstein et al evaluated the influence of a short period of moderate beer consumption on the status of the thrombolytic activity in patients with coronary artery disease (CAD). From 28 patients with two- or three-vessel CAD, 22 were randomly assigned to an experimental group (EG) and six to control group (CG). Before and after completion of the study, every one of the 28 patients was examined, and a wide range of laboratory tests was performed. The setting was a University Hospital in Israel. Of the EG, 22 patients consumed 330 mL of beer a day (20 g of alcohol) for the 30-day period in addition to the usual antiatherosclerotic diet. Patients of the CG did not consume alcohol beverages.

Fibrinogen, prothrombin time (PT), coagulant activity of Factor VII (F VIIc) and Factor (F VIIag), and plasminogen activator (PAI) levels were studied.

After the investigation, a statistically significant decrease was found in F VIIc (P < 0.01) and F VIIag (P < 0.001) and, to a lesser extent, a decrease in the value of PAI. Fibrinogen and PT remained unchanged in the EG also.

Even a short period of moderate beer consumption results in a decrease in thrombogenic activity. The only sensitive tests were F VIIc and F VIag. The decrease in thrombogenic activity may be the main cause of decreased mortality in patients with CAD who consume moderate quantities of alcoholic beverages.

COMMENT BY RALPH R. HALL, MD

So, it isn’t just the red wine that decreases the incidence of coronary artery disease complications. Beer may do it, too! One of my physician friends has been skeptical of the data indicating that red wine is protective against myocardial infarction. He thinks it’s the aspirin that one has to take the day after the red wine that is the effective agent. Perhaps the new study will convince him that it may be the alcohol.

High levels of F VIIc have been associated with increased risk of dying from coronary artery disease (CAD).1 In 15 of the 22 patients who drank beer, there was a decrease in F VIIc. No patient in this group had an increase in F VIIc.

Data from the Physicians’ Health Study published early this year conclude that 2-6 drinks per week have a favorable effect on all-cause mortality. "The difference between consumption of small and large amounts of alcohol may mean the difference between preventing and causing excess mortality."2

The data from the Physicians’ Health Study cannot be extrapolated to women because of the concern about breast cancer. In the Physicians’ Health Study, having two or more drinks per day was associated with a "sharp, significant increase in cancer deaths."

There are few, if any, negative effects of 4-6 drinks per week on patients with CAD. Those patients who cannot take aspirin may benefit from this precise dose of alcohol if given with the warning we give with all medication: Don’t take more than the recommended dose.

References

1. Miller, et al. Atherosclerosis 1986;60:269-277.

2. Camargo CA Jr, et al. Arch Intern Med 1997;157:79-85.