Cargando…
Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia
Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months. The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM. Ele...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428633/ https://www.ncbi.nlm.nih.gov/pubmed/28489799 http://dx.doi.org/10.1097/MD.0000000000006898 |
_version_ | 1783235864727388160 |
---|---|
author | Lu, Cheng-Hui Lee, Wen-Chen Wu, Michael Chen, Shao-Wei Yeh, Jih-Kai Cheng, Chun-Wen Wu, Katie Pei-Hsuan Wen, Ming-Shien Chen, Tien-Hsing Wu, Victor Chien-Chia |
author_facet | Lu, Cheng-Hui Lee, Wen-Chen Wu, Michael Chen, Shao-Wei Yeh, Jih-Kai Cheng, Chun-Wen Wu, Katie Pei-Hsuan Wen, Ming-Shien Chen, Tien-Hsing Wu, Victor Chien-Chia |
author_sort | Lu, Cheng-Hui |
collection | PubMed |
description | Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months. The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM. Electronic medical records from 1997 to 2011 were retrieved from the Taiwan National Health Insurance Research Database. Patients with PPCM were compared with age- and clinical characteristics-matched patients with DCM. Primary outcomes were 1- and 3-year heart failure (HF) readmission, cardiac death, all-cause mortality, and major adverse cardiovascular events. Secondary outcomes were myocardial infarction, new onset of dialysis, heart transplant, and cerebrovascular accident. Follow-up period was divided into “within the first year” and “after the first year.” A total of 527,979 patients (253,166 females) were hospitalized with a principal diagnosis of HF during 1997 to 2011 period. After excluding patients aged <18 and >50 years, patients with other forms of HF, and those with a history of cerebrovascular accidents or coronary artery disease, 797 patients with PPCM and 1267 patients with DCM were evaluated. Propensity score matching yielded 391 patients in each group. Patients with DCM had a significantly worse prognosis compared to those with PPCM for all primary and secondary outcomes at the 1- and 3-year follow-ups. After 1 year, the HF readmission rate did not significantly differ between the 2 diseases, suggesting that HF medications should be aggressively instituted in patients with PPCM. This is the first study to directly compare the clinical outcomes between age-matched patients with PPCM and DCM. Patients with PPCM had a significantly better prognosis across all cardiovascular endpoints compared to patients with DCM. |
format | Online Article Text |
id | pubmed-5428633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-54286332017-05-17 Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia Lu, Cheng-Hui Lee, Wen-Chen Wu, Michael Chen, Shao-Wei Yeh, Jih-Kai Cheng, Chun-Wen Wu, Katie Pei-Hsuan Wen, Ming-Shien Chen, Tien-Hsing Wu, Victor Chien-Chia Medicine (Baltimore) 5600 Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months. The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM. Electronic medical records from 1997 to 2011 were retrieved from the Taiwan National Health Insurance Research Database. Patients with PPCM were compared with age- and clinical characteristics-matched patients with DCM. Primary outcomes were 1- and 3-year heart failure (HF) readmission, cardiac death, all-cause mortality, and major adverse cardiovascular events. Secondary outcomes were myocardial infarction, new onset of dialysis, heart transplant, and cerebrovascular accident. Follow-up period was divided into “within the first year” and “after the first year.” A total of 527,979 patients (253,166 females) were hospitalized with a principal diagnosis of HF during 1997 to 2011 period. After excluding patients aged <18 and >50 years, patients with other forms of HF, and those with a history of cerebrovascular accidents or coronary artery disease, 797 patients with PPCM and 1267 patients with DCM were evaluated. Propensity score matching yielded 391 patients in each group. Patients with DCM had a significantly worse prognosis compared to those with PPCM for all primary and secondary outcomes at the 1- and 3-year follow-ups. After 1 year, the HF readmission rate did not significantly differ between the 2 diseases, suggesting that HF medications should be aggressively instituted in patients with PPCM. This is the first study to directly compare the clinical outcomes between age-matched patients with PPCM and DCM. Patients with PPCM had a significantly better prognosis across all cardiovascular endpoints compared to patients with DCM. Wolters Kluwer Health 2017-05-12 /pmc/articles/PMC5428633/ /pubmed/28489799 http://dx.doi.org/10.1097/MD.0000000000006898 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 5600 Lu, Cheng-Hui Lee, Wen-Chen Wu, Michael Chen, Shao-Wei Yeh, Jih-Kai Cheng, Chun-Wen Wu, Katie Pei-Hsuan Wen, Ming-Shien Chen, Tien-Hsing Wu, Victor Chien-Chia Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia |
title | Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia |
title_full | Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia |
title_fullStr | Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia |
title_full_unstemmed | Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia |
title_short | Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: A 15-year nationwide population-based study in Asia |
title_sort | comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: a 15-year nationwide population-based study in asia |
topic | 5600 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428633/ https://www.ncbi.nlm.nih.gov/pubmed/28489799 http://dx.doi.org/10.1097/MD.0000000000006898 |
work_keys_str_mv | AT luchenghui comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT leewenchen comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT wumichael comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT chenshaowei comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT yehjihkai comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT chengchunwen comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT wukatiepeihsuan comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT wenmingshien comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT chentienhsing comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia AT wuvictorchienchia comparisonofclinicaloutcomesinperipartumcardiomyopathyandagematcheddilatedcardiomyopathya15yearnationwidepopulationbasedstudyinasia |