Alcoholic cardiomyopathy (ACM) is a form of dilated cardiomyopathy (DCM) occurring secondary to long-standing heavy alcohol use and is associated with poor outcomes, but the cause-specific risks are insufficiently understood. Between 1997 and 2018, we identified all patients with a first diagnosis of ACM or DCM. The cumulative incidence of different causes of hospitalisation and mortality in the two groups was calculated using the Fine–Gray and Kaplan–Meier methods. A Total of 1,237 patients with ACM (mean age 56.3±10.1 years, 89% men) and 17,211 individuals with DCM (mean age 63.6±13.8 years, 71% men) were identified. Diabetes (10% vs 15%), hypertension (22% vs 31%), and stroke (8% vs 10%) were less common in ACM than DCM, whereas obstructive lung disease (15% vs 12%) and liver disease (17% vs 2%) were more prevalent (p<0.05). Cumulative 5-year mortality was 49% in ACM vs 33% in DCM, p<0.0001, multivariable adjusted hazards ratio 2.11 (95% confidence interval 1.97–2.26). The distribution of causes of death was similar in ACM and DCM, with the predominance of cardiovascular causes in both groups (42% in ACM vs 44% in DCM). 5-year cumulative incidence of heart failure hospitalisations (48% vs 54%) and any somatic cause (59% vs 65%) were also similar in ACM vs DCM. At 1 year, the use of beta blockers (55% vs 80%) and implantable cardioverter defibrillators (3% vs 14%) were significantly less often used in ACM vs DCM. Patients with ACM had similar cardiovascular risks and hospitalisation patterns as other forms of DCM, but lower use of guideline-directed cardiovascular therapies and greater mortality.

中文翻译：

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酒精与其他形式的扩张型心肌病的临床轨迹和长期结果

酒精性心肌病 (ACM) 是扩张型心肌病 (DCM) 的一种，继发于长期大量饮酒，与不良预后相关，但具体原因的风险尚不清楚。 1997 年至 2018 年间，我们确定了所有首次诊断为 ACM 或 DCM 的患者。使用 Fine-Gray 和 Kaplan-Meier 方法计算两组不同原因住院和死亡的累积发生率。总共确定了 1,237 名 ACM 患者（平均年龄 56.3±10.1 岁，89% 男性）和 17,211 名 DCM 患者（平均年龄 63.6±13.8 岁，71% 男性）。与 DCM 相比，糖尿病（10% vs 15%）、高血压（22% vs 31%）和中风（8% vs 10%）在 ACM 中较少见，而阻塞​​性肺病（15% vs 12%）和肝脏疾病（ 17% vs 2%）更为普遍（p<0.05）。 ACM 的 5 年累积死亡率为 49%，而 DCM 为 33%，p<0.0001，多变量调整风险比 2.11（95% 置信区间 1.97-2.26）。 ACM 和 DCM 的死因分布相似，两组均以心血管原因为主（ACM 为 42%，DCM 为 44%）。 ACM 与 DCM 中心力衰竭住院治疗的 5 年累积发生率（48% vs 54%）和任何躯体原因（59% vs 65%）也相似。 1 年时，与 DCM 相比，ACM 中 β 受体阻滞剂（55% vs 80%）和植入式心律转复除颤器（3% vs 14%）的使用频率明显较低。 ACM 患者与其他形式的 DCM 患者具有相似的心血管风险和住院模式，但指南指导的心血管治疗的使用率较低，死亡率较高。