Tymińska Agata, Ozierański Krzysztof, Balsam Paweł, Maciejewski Cezary, Wancerz Anna, Brociek Emil, Marchel Michał, Crespo-Leiro Maria G, Maggioni Aldo P, Drożdż Jarosław, Opolski Grzegorz, Grabowski Marcin, Kapłon-Cieślicka Agnieszka
First Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
Instituto de Investigaci on Biomedica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC)-CIBERCV, 15006 La Coruña, Spain.
Biology (Basel). 2022 Feb 21;11(2):341. doi: 10.3390/biology11020341.
Personalized management involving heart failure (HF) etiology is crucial for better prognoses for HF patients. This study aimed to compare patients with ischemic cardiomyopathy (ICM) and patients with non-ischemic dilated cardiomyopathy (NIDCM) in terms of baseline characteristics and prognosis. We assessed 895 patients with HF with reduced left ventricular ejection fraction participating in the Polish part of the European Society of Cardiology (ESC)-HF registries. ICM was present in 583 patients (65%), NIDCM in 312 patients (35%). The ICM patients were older ( < 0.001) and had more comorbidities. The NIDCM patients more frequently had atrial fibrillation ( = 0.04) and lower LVEF ( = 0.01); therefore, they were treated more often with anticoagulants ( = 0.01) and digitalis ( < 0.001). The NIDCM patients were prescribed aldosterone antagonists more often ( = 0.01). There were no other differences as regards the use of HF guideline-recommended medications, implantable cardioverter defibrillators or cardiac resynchronization therapy. The ICM patients were more likely to be treated with statins ( < 0.001) and antiplatelet agents ( < 0.001). All-cause death, as well as all-cause death and readmissions for HF at 12 months, occurred more often in the ICM group compared with the NIDCM group (15.9% vs. 10%, = 0.016; and 40.9% vs. 28.6%, = 0.00089, respectively). ICM etiology was an independent predictor of the composite endpoint in the total cohort ( = 0.003). The ICM patients were older and had more comorbidities, whereas the NIDCM patients had lower LVEF. One-year prognosis was worse in the ICM patients than in the NIDCM patients. ICM etiology was independently associated with a worse one-year outcome.
针对心力衰竭（HF）病因的个性化管理对改善HF患者的预后至关重要。本研究旨在比较缺血性心肌病（ICM）患者和非缺血性扩张型心肌病（NIDCM）患者的基线特征和预后。我们评估了895例参与欧洲心脏病学会（ESC）-HF注册研究波兰部分的左心室射血分数降低的HF患者。其中583例（65%）为ICM患者，312例（35%）为NIDCM患者。ICM患者年龄更大（<0.001）且合并症更多。NIDCM患者房颤发生率更高（=0.04）且左心室射血分数更低（=0.01）；因此，他们接受抗凝治疗（=0.01）和洋地黄治疗的频率更高（<0.001）。NIDCM患者使用醛固酮拮抗剂的频率更高（=0.01）。在HF指南推荐药物、植入式心脏复律除颤器或心脏再同步治疗的使用方面没有其他差异。ICM患者接受他汀类药物治疗（<0.001）和抗血小板药物治疗（<0.001）的可能性更大。与NIDCM组相比，ICM组全因死亡以及12个月时的全因死亡和HF再入院发生率更高（分别为15.9%对10%，=0.016；40.9%对28.6%，=0.00089）。ICM病因是整个队列中复合终点的独立预测因素（=0.003）。ICM患者年龄更大且合并症更多，而NIDCM患者左心室射血分数更低。ICM患者的1年预后比NIDCM患者更差。ICM病因与更差的1年结局独立相关。
