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Laboratory vs Clinical Detection

Rebecca Y. Wang, MD; Arthur I. Alterman, PhD; John S. Searles, PhD; A. Thomas McLellan, PhD

Arch Intern Med. 1990;150(5):1079-1082.

Abstract
• Detection of alcohol abuse is of utmost importance in the diagnosis and management of alcoholic cardiomyopathy. The ability of laboratory tests and clinical signs to detect alcohol abuse was compared in 31 patients with severe heart failure due to underlying dilated cardiomyopathy. Alcoholic cardiomyopathy was diagnosed in 13 patients and a variety of nonalcoholic cardiomyopathies were diagnosed in the remaining 18 patients. At the time of hospital admission, all patients received a complete cardiovascular examination as well as routine hematologic and biochemical tests. Details concerning past and recent alcohol intake were obtained by an individual who was unaware of the diagnostic status of the patients. The two groups of patients did not differ with respect to clinical presentation, self-report of recent drinking patterns, or clinical signs and medical history items that have been found to be associated with chronic alcohol abuse. However, the group with alcoholic cardiomyopathy had significantly higher values for mean corpuscular volume and -glutamyltranspeptidase. Our results suggest that a combination of routine laboratory tests may be effective in the detection of alcohol abuse in patients with dilated cardiomyopathy.

(Arch Intern Med. 1990;150:1079-1082)

Author Affiliations
From the Veterans Affairs Medical Center (Drs Wang, Alterman, Searles, and McLellan) and the University of Pennsylvania School of Medicine (Drs Alterman, Searles, and McLellan), Philadelphia.

Footnotes
Accepted for publication December 5,1989.

Reprint requests to 116 VA Medical Center, University and Woodland avenues, Philadelphia, PA 19104 (Dr Searles).

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