Fifteen-year mortality and prognostic factors in patients with dilated cardiomyopathy: persistent standardized application of drug therapy and strengthened management may bring about encouraging change in an aging society
Xiao-Rong XU
Meng-Meng HAN
Yi-Zhen YANG
Xin WANG
Dong-Yan HOU
Xian-Chen MENG
Hua WANG
Wen-Shu ZHAO
Lin ZHANG
Lin XU
1.Heart Center and Beijing Key Laboratory of Hypertension,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China2.Intensive Care Units,Beijing Longfu Hospital,Beijing,China3.Statistics Department,Information Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China
摘要：BACKGROUND There is scarce data on the long-term mortality and associated prognostic factors in patients with dilated car-diomyopathy (DCM). The study aimed to investigate the all-cause mortality up to 15 years (mean 7.9 ± 5.7 years) in such patients, and the independent prognostic factors influencing their long-term mortality.METHODS One hundred and sixty-six consecutive patients with DCM were prospectively enrolled from 2002 to 2003. The mean age of patients was 59.5 ± 10.4 years, and approximately 57％ were male. They were followed up by telephone or outpa-tient visit at least every three months until 2019 or all-cause death occurred. Predictors of mortality were identified using mul-tivariate logistic regression analysis. RESULTS During the 15 years of follow-up, five patients were lost to follow-up, and the complete data records of 161 patients were included in the analysis. Patients were treated with angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-recept-or blocker (ARB), β-blockers, mineralocorticoid receptor antagonist (MRA), diuretics and digitalis from 2002 to 2004, and main-tained at the maximum tolerated doses between 2004 and 2019. Our safety targets to maintain heart rate and blood pressure at 60-80 beats/min and 90-120/60-80 mmHg, respectively. All-cause mortality in the first five years was 55.9％. The independent risk factors for the 5-year mortality were age ≥ 70 years old (OR = 5.45, P = 0.006), systolic blood pressure (SBP) > 120 mmHg (OR =3.63, P = 0.004), 6-minute walk distance (6MWD) < 450 m (OR = 3.84, P = 0.001). 15-year all-cause mortality was 65.8％. The inde-pendent risk factors for 15-year mortality were age ≥ 70 years old (OR = 16.07, P = 0.009), LVEF ≤ 35％ (OR = 5.69, P = 0.003), and SBP > 120 mmHg (OR = 9.56, P < 0.001). CONCLUSIONS This study was the first to demonstrate the 15-year survival rate of 34％ in DCM patients. The DCM patients' first five-year all-cause mortality decreased significantly after continuous standardized treatment and intensive management. The mortality then plateaued in the following 10 years. Age ≥ 70 years, LVEF ≤ 35％, and SBP > 120 mmHg were independent predict-ors of 15-year all-cause mortality.
机标关键词：applicationmanagementchangewithaboutbringcardiomyopathydilated
论文发表日期：2022-05-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 335-342 )