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Eur J Heart Fail. 2017 Sep;19(9):1131-1141. doi: 10.1002/ejhf.780. Epub 2017 Mar 8.

Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM): EURObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM.

Author information

1
Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
2
Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
3
Hôpital Lariboisière, Université Paris Diderot, Inserm U 942, Paris, France.
4
Department of Cardiology and Angiology, Medical School Hannover, Hannover, Germany.
5
Golden Jubilee National Hospital, Glasgow, UK.
6
Eurobservational Research Program (EORP), European Society of Cardiology, Sophie Antipolis, France.
7
ANMCO Research Center, Firenze, Italy.
8
Institute of Gender in Medicine (GiM), Charité-Universitätsmedizin, Berlin, Germany.
9
Department of Medicine, Sahlgrenska University Hospital Ostra, Gothenburg, Sweden.
10
Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola, Italy.
11
University Medical Center Groningen, Groningen, The Netherlands.
12
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
13
Cardiology II, University Medical Center, Belgrade, Serbia.
14
Department of Genetics, Academic Medical Center, University of Amsterdam, The Netherlands.
15
Department of Cardiology, Lagos University Hospital, Lagos.
16
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.
17
Service de Cardiologie, Pôle Cardio-vasculaire et Pulmonaire, Hôpital Cardiologique, CHRU Lille, Lille Cedex, France.
18
Department of Cardiology, Charité-Universitätsmedizin, Berlin, Germany.
19
Department of Cardiology, University of East Anglia, UK.
20
Department of Heart Diseases, Medical University, Clinical Military Hospital, Poland.

Abstract

AIMS:

The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries.

METHODS AND RESULTS:

Out of 500 patients with PPCM entered by 31 March 2016, we report on data of the first 411 patients with completed case record forms (from 43 countries) entered into this ongoing registry. There were marked differences in socio-demographic parameters such as Human Development Index, GINI index on inequality, and Health Expenditure in PPCM patients from ESC vs. non-ESC countries (P < 0.001 each). Ethnicity was Caucasian (34%), Black African (25.8%), Asian (21.8%), and Middle Eastern backgrounds (16.4%). Despite the huge disparities in socio-demographic factors and ethnic backgrounds, baseline characteristics are remarkably similar. Drug therapy initiated post-partum included ACE inhibitors/ARBs and mineralocorticoid receptor antagonists with identical frequencies in ESC vs. non-ESC countries. However, in non-ESC countries, there was significantly less use of beta-blockers (70.3% vs. 91.9%) and ivabradine (1.4% vs. 17.1%), but more use of diuretics (91.3% vs. 68.8%), digoxin (37.0% vs. 18.0%), and bromocriptine (32.6% vs. 7.1%) (P < 0.001). More patients in non-ESC vs. ESC countries continued to have symptomatic heart failure after 1 month (92.3% vs. 81.3%, P < 0.001). Venous thrombo-embolic events, arterial embolizations, and cerebrovascular accidents were documented in 28 of 411 patients (6.8%). Neonatal death rate was 3.1%.

CONCLUSION:

PPCM occurs in women from different ethnic backgrounds globally. Despite marked differences in socio-economic background, mode of presentation was largely similar. Embolic events and persistent heart failure were common within 1 month post-diagnosis and required intensive, multidisciplinary management.

KEYWORDS:

Definition; Peripartum cardiomyopathy; Registry; Thrombotic events

PMID:
28271625
DOI:
10.1002/ejhf.780
[Indexed for MEDLINE]
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