Clinical Profile and Outcomes of Patients with Peripartum Cardiomyopathy in Africa: The Peripartum Cardiomyopathy Registry of EURObservational Research Programme

Background: Peripartum cardiomyopathy (PPCM) occurs globally, but there is significant variability in its epidemiology within and between countries. Objectives: In this post hoc analysis of PPCM data of EURObservational Research Programme, we aimed to compare the sociodemographic and clinical features, pattern of management, and 6-month clinical outcomes of the patients from six Sub-Saharan African (SSA) countries with those from Europe. Methods: Two hundred and eight PPCM patients were recruited from Burkina Faso (14.9%), Democratic Republic of Congo (1.9%), Mozambique (20.7%), Nigeria (22.6%), South Africa (34.1%), and Uganda (5.8%) between 2012 and 2018 and were compared with 249 PPCM patients from 23 European countries. Clinical outcomes were death from any cause, thromboembolism, stroke, and readmission to hospital for any cause. Results: All the SSA patients were Black, except for a minority of Caucasians (2.4%) and other races (9.6%) recruited from South Africa. Their baseline demographic and clinical characteristics differed significantly. The 249 patients recruited from Europe were more ethnically diverse (73.9% were Caucasians and 5.6% were Blacks) and were older, with a higher prevalence of diabetes, smoking, and atrial fibrillation. Patients from SSA had a higher prevalence of human immunodeficiency virus, multiparity, and prior history of PPCM. Although the frequencies of all-cause mortality and rehospitalization did not differ significantly between the various countries, European patients had more frequent left ventricular functional recovery at 6 months than the Africans. Conclusion: This comparative analysis demonstrated differences in the demographic and clinical characteristics among patients from the SSA countries and Europe. However, the rates of all-cause mortality and rehospitalization were similar.