Key result
Elevated creatinine linked to ~2.9-fold higher mortality in women with PPCM.
Why the study?
Peripartum cardiomyopathy disproportionately affects Black women, yet long-term outcome data and baseline predictors of survival, major adverse events, and LVEF recovery in socially vulnerable, predominantly Black cohorts remain limited.
Cohort (n=159)
In a predominantly Black U.S. cohort of women with peripartum cardiomyopathy followed for a median of 9 years, long-term mortality was high (25.8%) and LVEF recovery was low with frequent late relapse, underscoring the need for baseline risk stratification and prolonged echocardiographic surveillance.
Answers are grounded in this paper and cite their sources.
Elevated creatinine may refine mortality risk stratification in peripartum cardiomyopathy; leaves open prospective validation before clinical adoption.
BACKGROUND: Peripartum cardiomyopathy (PPCM) disproportionately affects Black women, yet long-term outcome data in socially vulnerable, predominantly Black cohorts remain limited. OBJECTIVES: The purpose of this study was to characterize long-term outcomes and baseline predictors of survival, major adverse events (MAEs), and left ventricular ejection fraction (LVEF) recovery in a U.S. PPCM cohort. METHODS: This retrospective-prospective registry included 159 women with PPCM (1982-2024). Primary outcomes were all-cause mortality, MAEs, and LVEF recovery (≥50%). Multivariable and extended Cox models evaluated predictors, adjusting for LVEF recovery and subsequent pregnancy. RESULTS: The cohort was 80.5% Black. Over a median 9.0-year follow-up (IQR: 3.4-15.5), 41 patients (25.8%) died and 64 (40.3%) had MAEs. Among 148 patients with echocardiographic follow-up, 69 (46.6%) had sustained LVEF recovery, though 23 (25.0% of initially recovered) declined to LVEF <50%. Independent mortality predictors included elevated creatinine (adjusted HR [aHR]: 2.86; 95% CI: 1.37-5.97), lower index LVEF (aHR: 0.94; 95% CI: 0.90-0.98), family history of cardiomyopathy or heart failure (aHR: 3.27; 95% CI: 1.41-7.56), and non-O blood type (aHR: 2.36; 95% CI: 1.04-5.33), retaining significance after adjusting for LVEF recovery and subsequent pregnancy (n = 62). Elevated creatinine increased MAE odds (adjusted OR: 7.09; 95% CI: 1.98-32.9), while higher LVEF, parity, and obesity reduced them. Baseline LV dilation (≥60 mm), Black race, older age, and family history of cardiomyopathy or heart failure predicted lower LVEF recovery odds. CONCLUSIONS: This long-term predominantly Black PPCM cohort had high mortality, low LVEF recovery, and frequent late relapse. These findings highlight the importance of baseline risk stratification and sustained echocardiographic surveillance to guide clinical decision-making.
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Santana et al. (2026) conducted a cohort in Peripartum cardiomyopathy (PPCM) (n=159). Baseline clinical predictors (e.g., elevated creatinine, lower index LVEF, family history of cardiomyopathy/HF, non-O blood type) vs. Absence of baseline risk predictors was evaluated on All-cause mortality, major adverse events (MAEs), and LVEF recovery (≥50%) (aHR 2.86, 95% CI 1.37-5.97). In women with PPCM, mortality was 25.8%, MAEs 40.3%, and sustained LVEF recovery 46.6%, with elevated creatinine predicting mortality.
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