Abstract 2959: Clinical Profile and Risk Predictors of Major Adverse Events in Patients with Peripartum Cardiomyopathy
Objectives. The aim of this study is to characterize the profile of major adverse events (MAE) in Peripartum Cardiomyopathy (PPCM) and to define risk factors associated with these events.
Methods. We performed a retrospective review of the clinical data of 172 patients (pts) with PPCM.
Results. A total of 42 pts had MAE, which were defined as death (13 pts), heart transplantation (10 pts), cardiopulmonary arrest (6 pts), pulmonary edema (of 5 pts), thromboembolic complications (3pts) and AICD implantation (5 pts). Main causes of mortality were sudden death (46%) and Heart Failure (46%). In 19 pts (45%) the occurrence of MAE preceded the diagnosis of PPCM. In 17 patients a delay of diagnosis ≥ 1 week from the onset of symptoms was reported. Seven (37%) the survivors had residual brain damage as a consequence of their MAE. The comparison of clinical characteristics between pts with and without MAE is presented in table 1⇓. Significant predictors of MAE using the Cox regression model were: EF ≤ 25% (HR 4.8, CI-2.1–10.8, p = 0.0002) and non Caucasian ethnic background (HR 2.3, CI 1.54 to 2.86. p = 0.015).These predictors in addition to diagnosis delay ≥ 1 week from onset of symptoms (HR 4.3, CI 1.10–23.2, p = 0.04) also predicted death or heart transplantation.
Conclusion. 1. PPCM can be associated with severe adverse events. 2.The incidence of these MAE is higher in non Caucasians women with single pregnancy and LVEF < 25% at time of at diagnosis. 3. Diagnosis of PPCM was often delayed and preceded by MAE. 4. Early diagnosis and aggressive approach including treatment of heart failure, anticoagulation and sudden death prevention should improve the outcome of patients with PPCM.