[Burden, trends and gender disparities of alcoholic cardiomyopathy in China from 1990 to 2021].

In 2021, the burden of alcoholic cardiomyopathy (ACM) in China included 28,103 prevalent cases, 1,861 deaths, and 64,746 DALYs.

• Prevalent cases: 28,103 (95% UI 22,175–34,991)
• Deaths: 1,861 (95% UI 318–2,987)
• DALYs: 64,746 person-years (95% UI 12,595–102,876 person-years)
• Corresponding rates per 100,000 population: prevalence 1.98 (95% UI 1.56–2.46), mortality 0.13 (95% UI 0.02–0.21), DALYs 4.55 (95% UI 0.89–7.23)

ACM burden in China increased substantially from 1990 to 2021, with prevalence, mortality, and DALY rates rising to multiples of their 1990 values.

• The prevalence of ACM in China in 2021 was 4.1-fold that of 1990
• Mortality rate in 2021 was 3.3-fold that of 1990
• DALYs rate in 2021 was 2.8-fold that of 1990
• Data sourced from the Global Burden of Disease 2021 study database

Average annual percentage changes (AAPCs) in ACM prevalence, mortality, and DALY rates from 1990 to 2021 were all positive, showing an overall trend of initial increase followed by stabilization.

• AAPC for prevalence rate: 4.96% (95% CI 4.67%–5.25%)
• AAPC for mortality rate: 3.94% (95% CI 3.63%–4.24%)
• AAPC for DALY rate: 3.65% (95% CI 3.36%–3.93%)
• Overall trend described as 'initial increase followed by stabilization'

ACM burden metrics peaked at different time periods, with the highest annual percentage changes occurring in the early-to-mid 2000s.

• Annual percentage change for prevalence peaked at 15.73% (95% CI 14.51%–16.96%) during 2000–2004
• Annual percentage change for mortality peaked at 8.42% (95% CI 7.89%–8.96%) during 2004–2011
• Annual percentage change for DALYs peaked at 9.80% (95% CI 8.72%–10.89%) during 2005–2009
• Analysis performed using Joinpoint regression model

The age distribution of ACM burden followed an inverted U-shaped pattern, with peaks in middle-aged groups.

• Peaks of case number and prevalence rate occurred in the 45–54 years age group
• Peaks of death number and DALYs occurred in the 50–59 years age group
• The disease burden exhibited an inverted U-shaped distribution with age

Males bore a substantially higher burden of ACM than females across all age groups under 90 years.

• Overall prevalence rate in males was 7.4-fold that of females
• Overall mortality rate in males was 7.7-fold that of females
• Overall DALY rate in males was 12.1-fold that of females
• Male predominance was observed across all age groups under 90 years for prevalence, mortality, and DALYs

Decomposition analysis identified epidemiological factors as the primary driver of changes in ACM burden in China, followed by population aging and population growth.

• Epidemiological factors contribution ratio: 43.56%–67.17%
• Population aging contribution ratio: 19.98%–33.56%
• Population growth contribution ratio: 12.84%–22.88%
• Decomposition analysis attributed burden changes to three independent factors: population growth, population aging, and changes in epidemiological rates