Key result
Ischemic cardiomyopathy in HFrEF patients was associated with higher all-cause mortality (27.5% vs 19.6%) and sudden cardiac death compared to non-ischemic cardiomyopathy.
Why the study?
Different heart failure etiologies carry distinct prognostic risk factors, making the prognostic assessment of ICM versus NICM clinically important.
Does ischemic cardiomyopathy etiology increase the risk of all-cause mortality and sudden cardiac death compared to non-ischemic cardiomyopathy in patients with HFrEF?
Cohort (n=873)
Does ischemic cardiomyopathy etiology increase the risk of all-cause mortality and sudden cardiac death compared to non-ischemic cardiomyopathy in patients with HFrEF?
Answers are grounded in this paper and cite their sources.
In patients with HFrEF, ischemic cardiomyopathy is associated with a higher risk of all-cause mortality and sudden cardiac death compared to non-ischemic cardiomyopathy, with distinct prognostic risk factors for each etiology.
OBJECTIVES: The different etiology of HF has different prognostic risk factors. Prognosis assessment of ICM and NICM has important clinical value. This study is aimed to explore the predicting factors for ICM and NICM. METHODS: 1082 HFrEF patients were retrospectively enrolled from Jan. 01, 2016 to Dec. 31, 2017. On Jan. 31, 2019, 873 patients were enrolled for analysis excluding incomplete, unfollowed, and unexplained data. The patients were divided into ischemic and non-ischemic group. The differences in clinical characteristics and long-term prognosis between the two groups were analyzed, and multivariate Cox analysis was used to predict the respective all-cause mortality, SCD and rehospitalization of CHF. RESULTS: 873 patients aged 64(53,73) were divided into two groups: ICM (403, 46.16%) and NICM. At the end, 203 died (111 in ICM, 54.68%), of whom 87 had SCD (53 in ICM, 60.92%) and 269 had rehospitalization for HF(134 in ICM, 49.81%). Independent risk factors affecting all-cause mortality in ICM: DM, previous hospitalization of HF, age, eGFR, LVEF; for SCD: PVB, eGFR, Hb, revascularization; for readmission of HF: low T3 syndrome, PVB, DM, previous hospitalization of HF, eGFR. Otherwise; factors affecting all-cause mortality in NICM: NYHA III-IV, paroxysmal AF/AFL, previous hospitalization of HF, β-blocker; for SCD: low T3 syndrome, PVB, nitrates, sodium, β-blocker; for rehospitalization of HF: paroxysmal AF/AFL, previous admission of HF, LVEF. CONCLUSIONS: Both all-cause mortality and SCD in ICM is higher than that in NICM. Different etiologies of CHF have different risk factors affecting the prognosis.
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Zhang et al. (2020) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=873). Ischemic cardiomyopathy vs. Non-ischemic cardiomyopathy was evaluated on All-cause mortality. Ischemic cardiomyopathy in HFrEF patients was associated with higher all-cause mortality (27.5% vs 19.6%) and sudden cardiac death compared to non-ischemic cardiomyopathy.
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