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Moderate alcohol acceptable for warfarin, lovastatin users
Moderate alcohol intake does not alter warfarin and lovastatin efficacy in postoperative coronary heart disease patients, research published in the American Journal of Medicine shows.
The study included data from 1244 men enrolled in the Post-Coronary Artery Bypass Graft (CABG) Trial who had been randomly assigned to receive a low or high dose of lovastatin, and low-dose warfarin (target international normalized ratio [INR]=1.4) or placebo.
The patients were followed-up for alanine aminotransferase (ALT) levels and INR at 6–12 week intervals for 4–5 years. In addition, the participants' weekly alcohol intake was classified as abstentious (<1 drink), light (1–6 drinks), moderate (7–13 drinks), or heavy (≥14 drinks). Lead author Kenneth Mukamal (Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA) and co-workers found that 66% of men had an INR of 2.0 or more during follow-up, and 7% had an elevated ALT level of 80 IU/l or more.
However, the maximum INR and ALT values did not differ significantly across the different alcohol intake patient groups.Specifically, INRs of 2.0 or more were detected in 67%, 66%, 68%, and 61% of men with abstentious, light, moderate, or heavy drinking patterns, respectively, with elevated ALT values found in 8%, 10%, 9%, and 6% of these groups.
"Among men who had undergone previous CABG surgery, we found little evidence that moderate alcohol use affects the safety of either lovastatin or low-dose warfarin, as measured by ALT and INR levels," Mukamal et al conclude.