Fang Wei, Luo Rong, Tang Yibin, Hua Wei, Fu Michael, Chen Weizhong, Lai Li, Li Xiaoping
Medical School of the University of Electronic Science and Technology of China Institute of Cardiovascular Disease, Chengdu Medical College Department of Laboratory Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, Göteborg, Sweden Department of Radiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan.
Medicine (Baltimore). 2018 Aug;97(31):e11744. doi: 10.1097/MD.0000000000011744.
Alcoholic cardiomyopathy (ACM) is considered one of the main causes of left ventricular dysfunction and is the leading cause of nonischemic dilated cardiomyopathy (DCM) in developed countries. However, very few studies have investigated the relationship between clinical characteristics and prognosis in ACM.
This study aimed to identify risk factors related to a poor outcome in ACM patients.
Retrospective cohort study.
This study included 321 patients with ACM admitted to our hospital between 2003 and 2013. This study aimed to investigate the clinical characteristics and outcomes of the patients with ACM, and the primary endpoint of the study was all-cause mortality, which was assessed through patient medical records (review of patient hospital records and periodic examination of patients in the outpatient clinic) and medical follow-up calls with trained personnel. All-cause mortality was assessed using Kaplan-Meier survival curves, and the risk factors were assessed using Cox regression. A receiver operating characteristic (ROC) curve analysis was performed to optimize the cutoff point for discriminating between the 2 risk groups.
After a median follow-up period of 3.78 years (interquartile range: 2.08-6.52 years), 83 (27.7%) patients were dead. The independent predictors of all-cause mortality due to ACM were the QRS duration (HR: 1.014; 95% CI: 1.004-1.019; P = .003), systolic blood pressure (HR: 0.980; 95% CI: 0.963- 0.997; P = .020), and New York Heart Association classification (HR: 1.595; 95% CI: 1.110-2.290; P = .011) at admission.
Our study indicated that the QRS duration, systolic blood pressure, and New York Heart Association classification at admission provided independent prognostic information in patients with ACM.
酒精性心肌病（ACM）被认为是左心室功能障碍的主要原因之一，并且是发达国家非缺血性扩张型心肌病（DCM）的主要病因。然而，极少有研究调查ACM患者的临床特征与预后之间的关系。
本研究旨在确定与ACM患者不良预后相关的危险因素。
回顾性队列研究。
本研究纳入了2003年至2013年间我院收治的321例ACM患者。本研究旨在调查ACM患者的临床特征和预后，研究的主要终点是全因死亡率，通过患者病历（查阅患者住院记录和在门诊定期检查患者）以及与经过培训的人员进行医疗随访电话来评估。使用Kaplan-Meier生存曲线评估全因死亡率，并使用Cox回归评估危险因素。进行受试者工作特征（ROC）曲线分析以优化区分两个风险组的截断点。
在中位随访期3.78年（四分位间距：2.08 - 6.52年）后，83例（27.7%）患者死亡。ACM所致全因死亡率的独立预测因素为入院时的QRS时限（HR：1.014；95%CI：1.004 - 1.019；P = 0.003）、收缩压（HR：0.980；95%CI：0.963 - 0.997；P = 0.020）和纽约心脏协会分级（HR：1.595；95%CI：1.110 - 2.290；P = 0.011）。
我们的研究表明，入院时的QRS时限、收缩压和纽约心脏协会分级为ACM患者提供了独立的预后信息。
