Characteristics of subjects with alcoholic cardiomyopathy and sudden cardiac death

• Published in: Heart (British Cardiac Society) Vol. 106; no. 9; pp. 686 - 690
• Main Authors: Hietanen, Siiri, Herajärvi, Johanna, Junttila, Juhani, Pakanen, Lasse, Huikuri, Heikki V, Liisanantti, Janne
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Cardiovascular Society 01.05.2020; BMJ Publishing Group LTD
• Subjects: Alcoholism; Cardiac arrest; cardiac risk factors and prevention; Cardiomyopathy; Cardiomyopathy, Alcoholic - complications; Cardiomyopathy, Alcoholic - diagnosis; Cardiomyopathy, Alcoholic - epidemiology; Cardiovascular disease; Cause of Death - trends; Coronary vessels; Criminal investigations; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Diabetes; Electrocardiography; Ethanol; Female; Finland - epidemiology; Follow-Up Studies; Forensic pathology; Heart failure; Heart failure and cardiomyopathies; Hospitals; Humans; Hypertension; Incidence; Liver cirrhosis; Male; Middle Aged; myocardial disease; Net income; Pancreatitis; Population; Prognosis; quality and outcomes of care; Retrospective Studies; Risk Factors; Statistical analysis; Studies; Survival Rate - trends; Urine; Finland; heart failure; myocardial disease; quality and outcomes of care; cardiac risk factors and prevention; cardiac arrest
• DOI: 10.1136/heartjnl-2019-315534
• ISSN: 1355-6037; 1468-201X

ObjectiveTo study social and clinical characteristics of victims of sudden cardiac death (SCD) due to alcoholic cardiomyopathy (ACM).MethodsThe study population comprised a subset of Fingesture cohort. All subjects were verified SCD victims determined to have ACM as cause of death in medico-legal autopsy between 1998 and 2017 in Northern Finland. The Finnish Population Register Centre provided SCD victims’ last place of residence. Population data of residential area were obtained from Statistics Finland.ResultsFrom a total of 5869 SCD victims in Fingesture cohort, in 290 victims the cause of SCD was ACM (4.9%; median age 56 (50–62) years; 83% males). In 64 (22.1%) victims, the diagnosis of cardiac disease was made prior to death and in 226 (77.9%) at autopsy. There were no significant differences in autopsy findings between victims with or without known cardiac diagnosis, but steatohepatitis (94.5%) and liver cirrhosis (64,5%) were common in both groups. Alcoholism was more often recorded in the known cardiac disease group (64.1% vs 47.3%, p=0.023). Majority were included in the working age population (ie, under 65 years) (54.8% and 53.1%, p=0.810). In high-income communities, 28.8% of ACM SCD victims had previously diagnosed cardiac disease, the proportion in the middle-income and low-income communities was 18.6% (p=0.05).ConclusionsMajority of SCD victims due to ACM did not have previously diagnosed cardiac disease, but documented risk consumption of alcohol was common. This emphasises the importance of routine screening of alcohol consumption and signs of cardiomyopathy in heavy alcohol users in primary healthcare.