Author + information
- Li Xiaofei,
- Sun Wei,
- Yao Yan,
- Lu Minjie,
- Hua Wei,
- Zhang Shu and
- Fan Xiaohan
The present study aimed to determine whether the combination of clinical risk factors may improve the prognostic value for clinical outcomes in non-ischemic cardiomyopathy (NICM) patients.
A total of 215 NICM patients in Fuwai hospital from December 2010 to April 2013 were prospectively enrolled in this cohort. Patients with known obstructive coronary heart disease, valvar heart disease, and hypertensive heart disease were excluded from this study. Baseline blood pressure, blood samples and left atrium size (by echocardiography) were obtained at admission. Patients were followed up by phone and clinical visits. The primary endpoint was defined as the composite of cardiovascular death, deterioration of heart failure (HF) for hospitalization heart transplantation and appropriate ICD therapy.
Of all the patients with NICM, 78.6% was male, the mean age was 37±12 years; and 73.9% was NYHA heart function III and IV. After three years' follow up, 95 patients (44.2%) met the primary endpoint (40 for cardiac death [18.6%], 45 for HF hospitalization [20.9%], 13 for appropriate ICD therapy [6.0%] and 8 for heart transplants [3.7%]). After adjusted age, sex and NYHA cardiac function by multivariate Cox analysis, the increased risk of clinical events were independently associated with Low systolic blood pressure (SBP)(SBP<90 mmHg, hazard ratio[HR] 3.92, 1.87-8.24), large left atrium(LA >51 mm, HR 2.38,1.45-3.93) and higher serum total bilirubin concentration(>36umol/L,1.95,1.25-3.03). Kaplan-Meier curves showed that individuals with three risk factors suffered higher clinical events as compared to those with 0-2 risk factors(76% vs 32%, log rank χ2=52.09, p<0.001).
Low systolic blood, large left atrium and higher serum total bilirubin concentration might be predictors for clinical events in patients with NICM, and patients with all of them might experience increased risk of 3-year cumulative clinical events.