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Comparison of long-term outcome of alcoholic and idiopathic dilated cardiomyopathy

L Fauchier1, D Babuty, P Poret

  • 1Service de Cardiologie B et Laboratoire d'électrophysiologie cardiaque, Centre Hospitalier Universitaire Trousseau, Tours, France.

European Heart Journal
|February 2, 2000
PubMed

Insights

Alcoholic cardiomyopathy outcomes are similar to idiopathic dilated cardiomyopathy, even with abstinence. Lack of alcohol cessation strongly predicts cardiac death, highlighting the need for aggressive treatment strategies.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Toxicology

Background:

  • Alcoholic cardiomyopathy (ACM) is often presumed to have a better prognosis than idiopathic dilated cardiomyopathy (IDCM) with alcohol abstinence.
  • Previous studies suggest improved outcomes for ACM patients who abstain from alcohol.

Purpose of the Study:

  • To compare the long-term clinical outcomes of alcoholic cardiomyopathy versus idiopathic dilated cardiomyopathy.
  • To identify predictors of cardiac death in patients with dilated cardiomyopathy.

Main Methods:

  • A cohort of 134 patients with dilated cardiomyopathy underwent comparison: 50 with ACM and 84 with IDCM.
  • Key cardiac function parameters, arrhythmia severity, heart rate variability, and signal-averaged ECG were assessed.
  • Follow-up averaged 47 months, with cardiac death as the primary endpoint.

Main Results:

  • Left ventricular dimensions, ejection fraction, cardiac index, arrhythmia severity, and heart rate variability were similar between ACM and IDCM groups.
  • Despite recommendations for alcohol withdrawal, only 70% of ACM patients achieved abstinence.
  • Cardiac death rates were comparable between the two groups after follow-up.

Conclusions:

  • Contrary to prior beliefs, ACM patients did not demonstrate a better outcome than IDCM patients.
  • Alcoholism and lack of abstinence were significant independent predictors of cardiac death.
  • A more intensive approach to alcohol cessation is crucial for improving outcomes in ACM patients.
Abstract

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