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Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM)
Sliwa-Hahnle, Karen Mebazaa, Alexandre Hilfiker-Kleiner, Denise Petrie, Mark C. Maggioni, Aldo P. Laroche, Cecile Regitz-Zagrosek, Vera Schaufelberger, Maria Tavazzi, Luigi van der Meer, Peter
Sliwa-Hahnle, Karen
Mebazaa, Alexandre
Hilfiker-Kleiner, Denise
Petrie, Mark C.
Maggioni, Aldo P.
Laroche, Cecile
Regitz-Zagrosek, Vera
Schaufelberger, Maria
Tavazzi, Luigi
van der Meer, Peter
Author
Sliwa-Hahnle, Karen
Mebazaa, Alexandre
Hilfiker-Kleiner, Denise
Petrie, Mark C.
Maggioni, Aldo P.
Laroche, Cecile
Regitz-Zagrosek, Vera
Schaufelberger, Maria
Tavazzi, Luigi
van der Meer, Peter
Roos-Hesselink, Jolien W.
Seferovic, Petar
van Spandonck-Zwarts, Karin
Mbakwem, Amam
Bohm, Michael
Mouquet, Frederic
Pieske, Burkert
Hall, Roger
Ponikowski, Piotre
Bauersachs, J.
Mebazaa, Alexandre
Hilfiker-Kleiner, Denise
Petrie, Mark C.
Maggioni, Aldo P.
Laroche, Cecile
Regitz-Zagrosek, Vera
Schaufelberger, Maria
Tavazzi, Luigi
van der Meer, Peter
Roos-Hesselink, Jolien W.
Seferovic, Petar
van Spandonck-Zwarts, Karin
Mbakwem, Amam
Bohm, Michael
Mouquet, Frederic
Pieske, Burkert
Hall, Roger
Ponikowski, Piotre
Bauersachs, J.
Abstract
Aims: The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries. Methods and results: Out of 500 patients with PPCM entered by 31 March 2016, we report on data of the first 411 patients with completed case record forms (from 43 countries) entered into this ongoing registry. There were marked differences in socio-demographic parameters such as Human Development Index, GINI index on inequality, and Health Expenditure in PPCM patients from ESC vs. non-ESC countries (P < 0.001 each). Ethnicity was Caucasian (34%), Black African (25.8%), Asian (21.8%), and Middle Eastern backgrounds (16.4%). Despite the huge disparities in socio-demographic factors and ethnic backgrounds, baseline characteristics are remarkably similar. Drug therapy initiated post-partum included ACE inhibitors/ARBs and mineralocorticoid receptor antagonists with identical frequencies in ESC vs. non-ESC countries. However, in non-ESC countries, there was significantly less use of beta-blockers (70.3% vs. 91.9%) and ivabradine (1.4% vs. 17.1%), but more use of diuretics (91.3% vs. 68.8%), digoxin (37.0% vs. 18.0%), and bromocriptine (32.6% vs. 7.1%) (P < 0.001). More patients in non-ESC vs. ESC countries continued to have symptomatic heart failure after 1 month (92.3% vs. 81.3%, P < 0.001). Venous thrombo-embolic events, arterial embolizations, and cerebrovascular accidents were documented in 28 of 411 patients (6.8%). Neonatal death rate was 3.1%. Conclusion: PPCM occurs in women from different ethnic backgrounds globally. Despite marked differences in socio-economic background, mode of presentation was largely similar. Embolic events and persistent heart failure were common within 1 month post-diagnosis and required intensive, multidisciplinary management.
Keywords
Peripartum cardiomyopathy, definition, registry, thrombotic events
Date
2017
Type
Journal article
Journal
European Journal of Heart Failure
Book
Volume
19
Issue
9
Page Range
1131-1141
Article Number
ACU Department
Collections
Relation URI
DOI
Source URL
Event URL
Open Access Status
License
File Access
Controlled