Long-term outcome and predictors of outcome in patients with non-ischemic dilated cardiomyopathy.

International journal of cardiology

PubMedID: 27390998

Karatolios K, Holzendorf V, Richter A, Schieffer B, Pankuweit S, Competence Network Heart Failure Germany. Long-term outcome and predictors of outcome in patients with non-ischemic dilated cardiomyopathy. Int J Cardiol. 2016;220608-612.
BACKGROUND
The study objectives were to identify predictors of outcome and to assess the long-term outcome in patients with non-ischemic dilated cardiomyopathy (DCM).

METHODS AND RESULTS
From 2004 to 2008, 206 consecutive patients (age 52.1±12.6years) with non-ischemic DCM were prospectively enrolled in the study and followed up for a mean of 55.6±18.4months. Predictors of outcome were identified in a multivariable analysis with a Cox proportional hazards analysis. The primary endpoint was a composite of all-cause mortality or heart transplantation. During the follow-up period 47 patients died (22.8%) and 5 patients (2.4%) underwent heart transplantation for end-stage heart failure. For the primary end point, a systolic LVEF <35% (hazard ratio 2.56; 95% confidence interval 1.21-5.45; p=0.014), a prolonged QTc interval >440ms (hazard ratio 2.56; 95% confidence interval 1.24-3.83; p=0.007) and a GFR <60ml/min/1.73m(2) (hazard ratio 2.42; 95% confidence interval 1.36-4.29; p=0.003) were identified as independent predictors, whereas the presence of an LBBB, atrial fibrillation, mild mitral regurgitation or treatment with digitalis were not significantly related to outcome.

CONCLUSIONS
In patients with non-ischemic DCM, a reduced systolic LVEF <35%, a prolonged QTc interval >440ms and an abnormal renal function with a GFR <60ml/min/1.73m(2) are independent predictors of death or need for heart transplantation.