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Heart failure and cardiomyopathies
Original research
Characteristics of subjects with alcoholic cardiomyopathy and sudden cardiac death
  1. Siiri Hietanen1,2,
  2. Johanna Herajärvi2,
  3. Juhani Junttila3,
  4. Lasse Pakanen4,5,
  5. Heikki V Huikuri3,
  6. Janne Liisanantti1,2
  1. 1 Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland
  2. 2 Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
  3. 3 Oulu University Medical Research Center, Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
  4. 4 Forensic Medicine Unit, National Institute for Health and Welfare, Oulu, Finland
  5. 5 Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, Oulu, Finland
  1. Correspondence to Dr Siiri Hietanen, Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Oulu 90210, Finland; siiri.hietanen{at}student.oulu.fi

Abstract

Objective To study social and clinical characteristics of victims of sudden cardiac death (SCD) due to alcoholic cardiomyopathy (ACM).

Methods The 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.

Results From 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).

Conclusions Majority 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.

  • heart failure
  • myocardial disease
  • cardiac arrest
  • cardiac risk factors and prevention
  • quality and outcomes of care

https://doi.org/10.1136/heartjnl-2019-315534

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    Footnotes

    • Contributors All authors have contributed to the planning, conduct and reporting of the research.

    • Funding The Fingesture study received funding from Sigrid Juselius Foundation and Finnish Foundation for Cardiovascular Research. This study received funding also from Finnish Foundation for Alcohol Studies and Finnish Medical Society Duodecim.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.