Dissecting burden of alcoholic cardiomyopathy: age-period-cohort analysis from the global burden of disease study 2019

BACKGROUND: Alcoholic cardiomyopathy (ACM) is a major cause of cardiovascular morbidity and mortality, characterized by ventricular dilation and impaired contractility resulting from chronic heavy alcohol use. Understanding its temporal and demographic trends is vital for guiding targeted public health interventions. METHODS AND FINDINGS: Using the Global Burden of Disease (GBD) 2019 dataset, we analyzed ACM trends from 1990 to 2019 across 204 countries and territories. Multi-level mixed-effects models were applied to assess age, period, and cohort effects on ACM mortality. Males consistently exhibited higher ACM rates across all age groups. Although global age-standardized prevalence and mortality rates have declined since 1990, regional disparities persist-mortality remains highest in Eastern Europe and lowest in Sub-Saharan Africa. Age, period, and cohort analyses revealed patterns reflecting cumulative alcohol-related cardiac damage, healthcare advancements, and generational shifts in alcohol consumption. CONCLUSIONS: Despite global improvement, ACM continues to impose a substantial health burden. Early interventions and policies addressing alcohol use throughout the life course are essential. Future longitudinal studies should identify critical prevention windows and explore genetic and environmental interactions. Advances in precision medicine, big data, and artificial intelligence may further enhance personalized treatment and optimize global resource allocation against ACM.