Figure 1. Scematic diagram of important metabolic effects of alcohol and its degradation products, acetaldehyde and acetate. Many of these changes affect the metabolism of fatty acids, the main fuel for the heart muscle's energy production. Fatty acid ethyl esters (FAEE) are potentially toxic derivatives of fatty acids. Nicotinamide adenine dinucleotide (NAD) is a coenzyme that plays an accessory role in enzyme catalysis. NADH is the reduced form of NAD.