Eight-Year Survival Analysis of Patients With Dilated Cardiomyopathy: Does Treatment Era Affect Prognosis?

Background Dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF). We retrospectively analyzed long-term survival in DCM and the impact of clinical factors on their prognosis. Methods This was a retrospective analysis of 622 DCM patients (484 men, 138 women). Survival was compared between the 2016-2019 and 2020-2023 cohorts. Results The mean age was similar between cohorts (54 ± 13 vs. 55 ± 13 years). Mean overall survival for the entire cohort was 84.1 ± 1.6 months (95% CI: 81.0-87.4). When analyzed by period, mean survival was 84.1 ± 2.0 months (95% CI: 80.3-87.9) for patients diagnosed between 2016 and 2019 and 53.4 ± 1.1 months (95% CI: 51.2-55.6) for those diagnosed between 2020 and 2023. The difference was not statistically significant (log-rank p = 0.856). The shorter mean survival in the later period reflects the limited follow-up time due to ongoing observation. In the 2020-2023 group, a higher proportion of patients were classified as New York Heart Association (NYHA) III/IV (56% vs. 48%, p = 0.036) and had larger ventricular diameters (left ventricular end-diastolic diameter (LVEDD): 68 ± 8 mm vs. 66 ± 7 mm, p = 0.001; right ventricle (RV): 36 ± 7 mm vs. 34 ± 6 mm, p = 0.001). Treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i) did not significantly affect survival. Multivariable analysis identified older age, NYHA class III/IV, chronic kidney disease (CKD) stages 3-5, diabetes, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) >3000 ng/L as independent negative predictors, while female sex and overweight status were associated with better survival. Multivariable analysis identified older age, NYHA III/IV, CKD stages 3-5, diabetes, and NT-proBNP >3000 ng/L as independent negative predictors. Female sex and overweight status were associated with improved survival. Conclusions Survival in DCM patients remained stable across time periods, despite a higher-risk profile in recent years, potentially influenced by the COVID-19 pandemic.