Improved Long-Term Prognosis of Dilated Cardiomyopathy With Implementation of Evidenced-Based Medication – Report From the CHART Studies –

Autor: Ryoichi, Ushigome, Yasuhiko, Sakata, Kotaro, Nochioka, Satoshi, Miyata, Masanobu, Miura, Soichiro, Tadaki, Takeshi, Yamauchi, Kenjiro, Sato, Takeo, Onose, Kanako, Tsuji, Ruri, Abe, Jun, Takahashi, Hiroaki, Shimokawa, Hiroko, Hamada
Rok vydání: 2015
Předmět:
Cardiomyopathy
Dilated
Male
medicine.medical_specialty
medicine.drug_class
Adrenergic beta-Antagonists
Cardiomyopathy
Angiotensin-Converting Enzyme Inhibitors
Comorbidity
Japan
Sodium Potassium Chloride Symporter Inhibitors
Cause of Death
Internal medicine
Diabetes Mellitus
Humans
Medicine
Prospective Studies
Registries
Prospective cohort study
Life Style
Beta blocker
Aged
Dyslipidemias
Mineralocorticoid Receptor Antagonists
Proportional Hazards Models
Cause of death
Evidence-Based Medicine
business.industry
Incidence
Mortality rate
Cardiovascular Agents
Dilated cardiomyopathy
General Medicine
Middle Aged
Prognosis
medicine.disease
Drug Utilization
Treatment Outcome
Cardiovascular Diseases
Heart failure
Hypertension
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Angiotensin II Type 1 Receptor Blockers
Dyslipidemia
Follow-Up Studies
Zdroj: Circulation Journal. 79:1332-1341
ISSN: 1347-4820
1346-9843
DOI: 10.1253/circj.cj-14-0939
Popis: Recent trends in the clinical characteristics, management and prognosis of dilated cardiomyopathy (DCM) remain to be examined in Japan.We compared 306 and 710 DCM patients in the Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-1 (2000-2005, n=1,278) and the CHART-2 (2006-present, n=10,219) Studies, respectively. Between the 2 groups of DCM patients, there were no significant differences in baseline characteristics. The prevalence of hypertension, dyslipidemia and diabetes mellitus were all significantly increased from the CHART-1 to the CHART-2 Study. The use of β-blockers and aldosterone antagonists was significantly increased, while that of loop diuretics and digitalis was significantly decreased in the CHART-2 Study. The 3-year mortality rate was significantly improved from 14% in the CHART-1 to 9% in the CHART-2 Study (adjusted HR, 0.60; 95% CI: 0.49-0.81; P=0.001). In particular, 3-year incidence of cardiovascular death was significantly decreased (adjusted HR, 0.26; 95% CI: 0.14-0.50, P0.001), while that of HF admission was not (adjusted HR, 0.90; 95% CI: 0.59-1.37, P=0.632). The prognostic improvement was noted in patients with BNP220 pg/ml, LVEF40%, β-blocker use and aldosterone antagonist use.Long-term prognosis of DCM patients has been improved, along with the implementation of evidence-based medication in Japan.
Databáze: OpenAIRE
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