Demographic Influence On Outcomes In Postpartum Cardiomyopathy

• Published in: Journal of cardiac failure 2023-04, Vol.29 (4), p.645-646
• Main Authors: Kogler, William, Kandah, Fadi, Karan, Abhinav, Adeyemo, Adefemi, Palacio, Carlos, Ruiz, Jose, Miller, Alan, Missov, Emil
• Format: Article
• Language: English
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2022.10.243

Postpartum Cardiomyopathy is a pregnancy associated disease resulting in left ventricular dysfunction and heart failure that arises in the peripartum period, or up to 5 months postpartum. It remains relatively rare however its incidence has been increasing over the years. It is established that this disease is more prevalent in certain populations such as minorities or patients with multiple comorbidities. However it is unclear how these populations are affected in terms of mortality and heart failure admission. Aim: This study examines differences in adverse outcomes, mortality, and heart failure hospitalizations in patients with postpartum cardiomyopathy based on demographic data and baseline risk factors, in order to identify potential prognostic factors. Our study was a retrospective single center cohort study of patients diagnosed with postpartum cardiomyopathy between the year 2000-2020. 132 patients with post-partum cardiomyopathy were initially identified of which 38 were excluded based on inclusion criteria or lack of follow up. We analyzed specific demographics and risk factors including race, BMI, diabetes, smoking, degree of left ventricular dysfunction at diagnosis, and pregnancy history. We compared these sequentially to outcomes which included recovery of left ventricular ejection fraction (= or >50%), mortality (30 day, 1 year, overall), heart failure hospitalizations, thrombotic events, MI, and arrhythmias. The data was collected via chart review of the electronic medical records, data analysis was performed using SPSS software. The primary endpoint of this study was to evaluate outcomes as compared to different demographics and risk factors as outlined above. In terms of mortality, recovery of ejection fraction, chronic heart failure, thrombotic events, MI, and arrhythmia post diagnosis, there was no statistical difference between the baseline characteristics. However, in terms of heart failure hospitalizations following diagnosis, we found that African Americans were 4 times more likely to be hospitalized than Caucasians (41.2% vs 13.6%, OR= 4.4, p = 0.04). In addition, the odds of being hospitalized for heart failure was 4 times higher in diabetics than non-diabetics (61.1% vs 27.6%, LR = 6.9, p = 0.009). Other races made up only 3 patients and were not statistically significant. In our study patients with postpartum cardiomyopathy who were African American, and/or had diabetes had an increased likelihood of heart failure hospitalizatio