Alcohol and Heart Health; A Public Health Concern

Abstract

Introduction: Alcoholic cardiomyopathy (AC) results due to the consumption of high levels of alcohol on a long-term basis. Its prevalence varies and ranges from 4 to 40 percent. Although AC makes up approximately 4% of all cardiomyopathies, it is the second most common cause of dilated cardiomyopathy. We herein explore the outcomes of percutaneous coronary intervention (PCI) among patients with AC. Methods: This is a cross-sectional study of the National Inpatient Sample (NIS) for hospital discharges in the United States between 2012 to 2014. We identified the number of patients with a primary or secondary diagnosis of AC using the ICD-9 code of 4.255. Using the ICD-9 code for PCI (00.66, 36.01, 36.02, 36.05, 36.06, 36.07, 17.55), we identified patients diagnosed with AC who underwent a PCI (AC/PCI). Hospital length of stay (LOS), death, cost of hospitalization, and cardiovascular outcomes, including atrial fibrillation (AF) and Ventricular fibrillation (VF) were compared between patients with and without AC who underwent a PCI. Results: A total of 2,488,293 PCIs were performed between 2012 to 2014. Of these, there were a total of 161 admissions for alcoholic cardiomyopathy. The patients with AC/PCI were likely to stay longer in the hospital, with an average stay of 6.6 days (SD = 6.2) compared to patients without AC undergoing PCI -3.7 days (SD = 5.0) (p=0.0001). The mean hospital charge for patients with AC/PCI was $120,225 (SD=101,044), while that of those without AC who underwent PCI was $87,936 (SD=83,947) (p=0.0001). A higher death rate during hospitalization, 3.7%, was recorded in the AC/PCI category vs. 2.3% in patients without AC who underwent PCI (p=0.0001). Patients with AC/PCI had a higher prevalence of AF (30.4%) than VF (7.5%). Conclusion: Alcohol abuse increases the disease burden and continues to be a public health concern. Despite the decreased prevalence compared to their non-AC/PCI counterparts, the AC/PCI group had poorer hospital outcomes. Further studies are needed to explore the burden of long-term alcohol consumption on cardiovascular disease treatment outcomes.