Immunosuppressive therapy improved heart transplantation-free survival compared with standard heart failure therapy alone in patients with inflammatory cardiomyopathy (HR 0.34; 95% CI 0.17-0.92; P=0.043).
Cohort (n=209)
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Does immunosuppressive therapy improve heart transplantation-free survival and LVEF in patients with virus-negative nonfulminant inflammatory cardiomyopathy?
Immunosuppressive therapy added to standard heart failure treatment may significantly improve heart transplantation-free survival and left ventricular ejection fraction in patients with virus-negative nonfulminant inflammatory cardiomyopathy.
Hazard Ratio: 0.34 (95% CI 0.17–0.92)
valor p: p=0.043
Background: Inflammatory cardiomyopathy (infl-CMP) is characterized by increased cardiac inflammation in the absence of viruses, ischemia, valvular disease, or other apparent causes. Studies addressing the efficacy of immunosuppressive therapy in patients with infl-CMP are sparse. This study retrospectively investigates whether immunosuppressive agents on top of heart failure therapy according to current guidelines improves cardiac function and long-term outcome in patients with infl-CMP. Methods and Results: Within the Innsbruck and Maastricht Cardiomyopathy Registry, a total of 209 patients fulfilled the criteria for infl-CMP using endomyocardial biopsy (≥14 infiltrating inflammatory cells/mm 2 ). A total of 110 (53%) patients received immunosuppressive therapy and 99 (47%) did not. To correct for potential selection bias, 1:1 propensity score matching was used on all significant baseline parameters, resulting in a total of 90 patients per group. Baseline characteristics did not significantly differ between both patient groups, reflecting optimal propensity score matching. After a median follow-up of 31 (15–47) months, immunosuppressive therapy resulted in an improved long-term outcome (eg, heart transplantation–free survival) as compared with standard heart failure therapy alone (Log-rank P =0.043; hazard ratio, 0.34 95% CI, 0.17–0.92) and in a significant larger increase of left ventricular ejection fraction after a mean of 12 months follow-up, as compared with patients receiving standard heart failure treatment only (12.2% versus 7.3%, respectively; P =0.036). Conclusions: To conclude, this study suggests that immunosuppressive therapy in infl-CMP patients results in an improved heart transplantation–free survival as compared with standard heart failure therapy alone, underscoring the urgent need for a large prospective multicenter trial.
Merken et al. (Thu,) conducted a cohort in Virus-Negative Nonfulminant Inflammatory Cardiomyopathy (n=209). Immunosuppressive therapy vs. Standard heart failure therapy alone was evaluated on Heart transplantation-free survival (HR 0.34, 95% CI 0.17-0.92, p=0.043). Immunosuppressive therapy improved heart transplantation-free survival compared with standard heart failure therapy alone in patients with inflammatory cardiomyopathy (HR 0.34; 95% CI 0.17-0.92; P=0.043).