Key result
Higher Gensini score linked to ~12% higher MACE risk in non-ischemic dilated cardiomyopathy.
Why the study?
The impact of coronary atherosclerotic burden on prognosis in patients with non-ischemic dilated cardiomyopathy is lesser known.
Does coronary atherosclerotic burden predict major adverse cardiovascular events in patients with non-ischemic dilated cardiomyopathy?
Cohort (n=139)
No
Does coronary atherosclerotic burden predict major adverse cardiovascular events in patients with non-ischemic dilated cardiomyopathy?
Odds Ratio: 1.12 (95% CI 1.01–1.23)
p-value: p=0.02
Higher coronary atherosclerotic burden, measured by Gensini score, is an independent predictor of major adverse cardiovascular events in patients with non-ischemic dilated cardiomyopathy.
May support risk stratification in non-ischemic dilated cardiomyopathy; leaves open need for prospective validation before clinical use.
Background: Atherosclerosis is associated with a worse prognosis in many diseases such as ischemic cardiomyopathy, but its impact in non-ischemic dilated cardiomyopathy (dCMP) is lesser known. Our aim was to study the prognostic impact of coronary atherosclerotic burden (CAB) in patients with dCMP. Methods: Consecutive patients with dCMP and left ventricular (LV) dysfunction diagnosed by concomitant analysis of invasive coronary angiography (ICA) and CMR imaging were identified from registry-database. CAB was measured by Gensini score. The primary composite endpoint was the occurrence of major adverse cardiovascular events (MACE) defined as cardiovascular (CV) mortality, non-fatal MI and unplanned myocardial revascularization. The results of 139 patients constituting the prospective study population (mean age 59.4 ± 14.7 years old, 74% male), average LV ejection fraction was 31.1 ± 11.02%, median Gensini score was 0 (0–3), and mid-wall late gadolinium enhancement (LGE) was the most frequent LGE pattern (42%). Over a median follow-up of 2.8 years, 9% of patients presented MACE. Patients with MACE had significantly higher CAB compared to those who were free of events (0 (0–3) vs. 3.75 (2–15), p < 0.0001). CAB remained the significant predictor of MACE on multivariate logistic analysis (OR: 1.12, CI: 1.01–1.23, p = 0.02). Conclusion: High CAB may be a new prognostic factor in dCMP patients.
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Canu et al. (2021) conducted a cohort in Non-Ischemic Dilated Cardiomyopathy (n=139). Coronary atherosclerotic burden (Gensini score) vs. Lower coronary atherosclerotic burden was evaluated on Major adverse cardiovascular events (MACE) defined as cardiovascular mortality, non-fatal MI, and unplanned myocardial revascularization (OR 1.12, 95% CI 1.01-1.23, p=0.02). Higher coronary atherosclerotic burden, quantified by the Gensini score, independently predicted major adverse cardiovascular events in patients with non-ischemic dilated cardiomyopathy (OR 1.12).
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