Clinical characteristics, treatment and prognosis of patients with idiopathic dilated cardiomyopathy: a tertiary center experience.
Dilated cardiomyopathy
Heart failure
Medications
Prognosis
Journal
Journal of geriatric cardiology : JGC
ISSN: 1671-5411
Titre abrégé: J Geriatr Cardiol
Pays: China
ID NLM: 101237881
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
entrez:
21
5
2019
pubmed:
21
5
2019
medline:
21
5
2019
Statut:
ppublish
Résumé
Contemporary heart failure medications have led to considerable improvement in the survival of patients with heart failure. However, limited evidence is available regarding the effect of those medications in patients with idiopathic dilated cardiomyopathy (IDCM), particularly in China. We sought to analyze the trends in clinical characteristics and the prescription rate of recommended therapies and its prognostic impact in patients with IDCM. From 2009 to 2016, 1441 consecutive patients (age: 55±14 years, 68% men, LVEF: 33% ± 12%) fulfilling World Health Organization criteria for IDCM were enrolled in the current retrospective cohort study. Temporal trends of baseline clinical characteristics, treatment and prognosis were analyzed, and potential influential factors were explored. Rates of patients receiving angiotensin-converting enzyme inhibitors/angiotensin II receptors blockers, β-blockers, aldosterone receptor antagonists and diuretics increased from 55%, 45%, 58%, 51% in 2009 to 67%, 69%, 71%, 64% in 2016, respectively ( An improvement in prescription rates of guideline-recommended medications in IDCM patients was observed. However, it remains suboptimal, and there is still some room for improvement. The prognosis of patients with optimal GDMT was better than those without. Moreover, the following patient category also had an improved prognosis: patients with LVEF ≥ 40%, with device therapy, and those admitted to a cardiology ward.
Sections du résumé
BACKGROUND
BACKGROUND
Contemporary heart failure medications have led to considerable improvement in the survival of patients with heart failure. However, limited evidence is available regarding the effect of those medications in patients with idiopathic dilated cardiomyopathy (IDCM), particularly in China. We sought to analyze the trends in clinical characteristics and the prescription rate of recommended therapies and its prognostic impact in patients with IDCM.
METHODS
METHODS
From 2009 to 2016, 1441 consecutive patients (age: 55±14 years, 68% men, LVEF: 33% ± 12%) fulfilling World Health Organization criteria for IDCM were enrolled in the current retrospective cohort study. Temporal trends of baseline clinical characteristics, treatment and prognosis were analyzed, and potential influential factors were explored.
RESULTS
RESULTS
Rates of patients receiving angiotensin-converting enzyme inhibitors/angiotensin II receptors blockers, β-blockers, aldosterone receptor antagonists and diuretics increased from 55%, 45%, 58%, 51% in 2009 to 67%, 69%, 71%, 64% in 2016, respectively (
CONCLUSIONS
CONCLUSIONS
An improvement in prescription rates of guideline-recommended medications in IDCM patients was observed. However, it remains suboptimal, and there is still some room for improvement. The prognosis of patients with optimal GDMT was better than those without. Moreover, the following patient category also had an improved prognosis: patients with LVEF ≥ 40%, with device therapy, and those admitted to a cardiology ward.
Identifiants
pubmed: 31105752
doi: 10.11909/j.issn.1671-5411.2019.04.004
pii: jgc-16-04-320
pmc: PMC6503477
doi:
Types de publication
Journal Article
Langues
eng
Pagination
320-328Références
Lancet. 1999 Jan 2;353(9146):9-13
pubmed: 10023943
Eur Heart J. 2000 May;21(9):763-9
pubmed: 10739732
N Engl J Med. 2001 Dec 6;345(23):1667-75
pubmed: 11759645
Circulation. 2002 Apr 2;105(13):1585-91
pubmed: 11927527
Circulation. 2002 Oct 22;106(17):2194-9
pubmed: 12390947
Eur Heart J. 2003 Mar;24(5):464-74
pubmed: 12633547
Lancet. 2003 Sep 6;362(9386):772-6
pubmed: 13678870
Circulation. 2004 Aug 10;110(6):724-31
pubmed: 15289383
N Engl J Med. 2004 Aug 5;351(6):543-51
pubmed: 15295047
Eur Heart J. 2005 Dec;26(24):2706-13
pubmed: 16183692
N Engl J Med. 2006 Jul 20;355(3):251-9
pubmed: 16855265
Eur Heart J. 2007 Jun;28(11):1310-8
pubmed: 17185303
Eur Heart J. 2008 Jan;29(2):270-6
pubmed: 17916581
Am J Geriatr Cardiol. 2008 Jan-Feb;17(1):13-20
pubmed: 18174755
Heart Vessels. 2008 Jul;23(4):217-23
pubmed: 18649051
N Engl J Med. 2008 Dec 4;359(23):2456-67
pubmed: 19001508
Eur J Heart Fail. 2009 Jan;11(1):85-91
pubmed: 19147461
N Engl J Med. 2011 Jan 6;364(1):11-21
pubmed: 21073363
Circulation. 2012 Jul 3;126(1):65-75
pubmed: 22615345
J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239
pubmed: 23747642
Circ Heart Fail. 2013 Sep 1;6(5):913-21
pubmed: 23888044
Arch Cardiovasc Dis. 2014 Jan;107(1):21-32
pubmed: 24388162
Eur J Heart Fail. 2014 Mar;16(3):317-24
pubmed: 24464640
Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Feb;42(2):98-122
pubmed: 24735621
Tex Heart Inst J. 2014 Jun 01;41(3):253-61
pubmed: 24955039
Circ J. 2015;79(6):1332-41
pubmed: 25833177
Circulation. 2016 Dec 6;134(23):e579-e646
pubmed: 27832612
Rev Esp Cardiol (Engl Ed). 2016 Dec;69(12):1167
pubmed: 27894487
Am J Cardiol. 1988 Jul 11;62(2):60A-66A
pubmed: 2839019
J Arrhythm. 2017 Oct;33(5):410-416
pubmed: 29021842