Persistent Inequalities and Rising Burden, 1990-2021: a 30-Year Global Portrait of Alcoholic Cardiomyopathy from the GBD 2021 Study

Aims: To investigate the epidemiological characteristics and risk factors of alcoholic cardiomyopathy, assess its health inequalities between 1990 and 2021, and project future disease burden, thereby mitigating its health hazards. Methods: This cross-sectional analysis utilized data from the Global Burden of Disease Study (GBD) 2021. Metrics included prevalence, deaths, disability-adjusted life years (DALYs), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized DALY rate (ASDR), case changes with estimated annual percentage changes, slope index of inequality (SII), and Concentration Index. Results: From 1990 to 2021, global prevalence, deaths, and DALYs cases for alcohol-related cardiomyopathy increased. Among five alcohol-related burden regions, the high SDI region had the highest prevalence numbers, and the high-middle SDI region had the highest death and DALYs numbers in 2021. Eastern Europe exhibited the highest regional prevalence, deaths, and DALYs cases, followed by ASPR, ASMR, and ASDR. Among 204 countries, the Russian Federation had the highest prevalence, deaths, and DALYs cases (followed by ASPR), while Latvia led in ASMR and ASDR. Between 1990 and 2021, the DALY SII increased, whereas the DALY Concentration Index declined. High alcohol consumption and extreme temperatures were key drivers of the rising burden. Projections suggest upward trends in prevalence, deaths, and DALYs across age groups over the next 30 years. Conclusion: The escalating burden of alcoholic cardiomyopathy from 1990 to 2021 underscores the urgent need for targeted interventions. Measures addressing risk factors and high-risk populations are essential to alleviate this trend.