{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T18:39:03Z","timestamp":1763491143293,"version":"3.45.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["(No.81960085"],"award-info":[{"award-number":["(No.81960085"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Guizhou Medical University Doctoral Research Initiation Fund","award":["gyfybsky-2022-44"],"award-info":[{"award-number":["gyfybsky-2022-44"]}]},{"DOI":"10.13039\/501100004001","name":"Guizhou Provincial Science and Technology Department","doi-asserted-by":"publisher","award":["gyfybsky-2022-44"],"award-info":[{"award-number":["gyfybsky-2022-44"]}],"id":[{"id":"10.13039\/501100004001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Alcoholic cardiomyopathy (ACM), a preventable yet overlooked cardiomyopathy subtype, disproportionately affects chronic alcohol users through alcohol-induced myocardial damage. Characterized by delayed clinical onset, ACM typically manifests as irreversible heart failure in middle age (45-69 years), creating missed opportunities for early intervention. Despite global cardiovascular mortality declines, ACM burden continues rising paradoxically in certain middle-high income countries like China, revealing gaps in current prevention strategies. This study systematically evaluates ACM\u2019s global burden through prevalence, mortality and disability-adjusted life years (DALYs) metrics, using WHO-standardized methods to characterize spatiotemporal patterns across global, national, and subnational strata.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We utilized the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 methodological framework to estimate the age-standardized rates (ASRs) of prevalenceand, mortality and DALYs for ACM. These estimates were stratified across key demographic dimensions including: Age groups (15-95+ years), Sex, Geographical regions (21 GBD-defined regions), the Socio-Demographic Index (SDI) quintiles, 204 countries and territories during the observation period 1990-2021. Furthermore, we employed Bayesian Age-Period-Cohort (BAPC) modeling with integrated nested Laplace approximations to project disease burden trajectories through 2036, incorporating uncertainty quantification via Markov chain Monte Carlo simulations.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Globally, ACM burden showed significant declines from 1990 to 2021, with age-standardized rates decreasing by 22.5-37.1% across prevalence, mortality and disability measures. However, China experienced a 200.4% case increase during this period, with rising mortality and disability rates contrary to global trends. The disease disproportionately affected males and middle-aged adults (45-69 years), with pronounced regional disparities in middle-high SDI areas. While population growth primarily drove disability-adjusted life year (DALY) increases, these regions also showed greatest potential for burden reduction through targeted interventions. Projections suggest continued global declines but only modest improvements in China through 2036.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In 2021, ACM remained a significant global health burden, particularly affecting middle-aged and elderly populations with distinct demographic disparities. This study identified three critical issues: China\u2019s unique epidemiological patterns, optimal intervention timing for high-risk populations, and sex-specific pathogenic mechanisms. Future research should prioritize developing precision prevention strategies for high-burden regions, including population-based alcohol control policies, early screening programs (especially for males aged 45-69), and personalized secondary prevention measures. Middle-high SDI regions warrant particular attention as priority intervention areas requiring cost-effectiveness implementation studies.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0336033","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T18:35:58Z","timestamp":1763490958000},"page":"e0336033","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiological trends in alcoholic cardiomyopathy burden: A 32-year global and Chinese analysis (1990\u20132021) with projections to 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