What is the clinical evidence from this study?

Study design: Cohort. Population: Dilated cardiomyopathy (n=134). Intervention: Alcoholic cardiomyopathy vs. Idiopathic dilated cardiomyopathy. Primary outcome: Cardiac death.

What does this research mean for the field?

Patients with alcoholic cardiomyopathy do not have better long-term outcomes than those with idiopathic dilated cardiomyopathy, and continued alcohol consumption without abstinence strongly predicts cardiac death. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

To compare the long-term clinical outcomes and survival between patients with alcoholic cardiomyopathy and idiopathic dilated cardiomyopathy.

April 26, 2026European Heart JournalOpen Access

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

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Key result

Alcoholic cardiomyopathy offers no prognostic advantage over idiopathic DCM, and continued alcoholism strongly predicts cardiac death.

n=134

Why the study?

Does alcoholic cardiomyopathy have a different long-term rate of cardiac death compared to idiopathic dilated cardiomyopathy?

Key Points

To compare the long-term clinical outcomes and survival between patients with alcoholic cardiomyopathy and idiopathic dilated cardiomyopathy.
Followed 134 patients with dilated cardiomyopathy and normal coronary angiography (50 with alcoholic cardiomyopathy, 84 with idiopathic dilated cardiomyopathy) over a mean duration of 47 ± 40 months.
Assessed baseline cardiac metrics, including left ventricular ejection fraction, ventricular arrhythmias, heart rate variability, and signal-averaged ECG, while tracking alcohol abstinence.
Identified independent predictors of cardiac death using multivariate analysis across the entire study cohort.
Alcohol cessation was achieved in 70% of patients with alcoholic cardiomyopathy, but cardiac death rates remained similar between the alcoholic and idiopathic cardiomyopathy cohorts over 47 ± 40 months.
Multivariate analysis showed that increased pulmonary capillary wedge pressure (P=0.003), continued alcoholism without abstinence (P=0.006), and decreased standard deviation of all normal-to-normal RR intervals (P=0.02) independently predicted cardiac death.

Study Design

Type

Cohort (n=134)

Structured PICO

Does alcoholic cardiomyopathy have a different long-term rate of cardiac death compared to idiopathic dilated cardiomyopathy?

Population

134 patients with dilated cardiomyopathy and normal coronary angiography (50 alcoholic, 84 idiopathic) followed for a mean of 47 months.

Exposure

Alcoholic cardiomyopathy

Comparator

Idiopathic dilated cardiomyopathy

Outcome

Cardiac death after follow-up treatment of 47+/-40 monthshard clinical

Contrary to previous beliefs, alcoholic cardiomyopathy does not have a better long-term prognosis than idiopathic dilated cardiomyopathy, and continued alcohol consumption strongly predicts cardiac death.

Discussion

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Implication

Alcohol abstinence may reduce cardiac death in alcoholic cardiomyopathy; challenges prior better-prognosis reports versus idiopathic disease but leaves open randomized confirmation.

Cite This Study

Laurent Fauchier (2000) conducted a cohort in Dilated cardiomyopathy (n=134). Alcoholic cardiomyopathy vs. Idiopathic dilated cardiomyopathy was evaluated on Cardiac death. Alcoholic cardiomyopathy had a similar rate of cardiac death compared to idiopathic dilated cardiomyopathy, while alcoholism without abstinence independently predicted cardiac death (P=0.006).

synapsesocial.com/papers/69ee2ce59de2ebe493710057 https://doi.org/10.1053/euhj.1999.1761

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Implication

Alcohol abstinence may reduce cardiac death in alcoholic cardiomyopathy; challenges prior better-prognosis reports versus idiopathic disease but leaves open randomized confirmation.

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

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

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

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider