PMID- 35722031 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220716 IS - 1671-5411 (Print) IS - 1671-5411 (Linking) VI - 19 IP - 5 DP - 2022 May 28 TI - Fifteen-year mortality and prognostic factors in patients with dilated cardiomyopathy: persistent standardized application of drug therapy and strengthened management may bring about encouraging change in an aging society. PG - 335-342 LID - 10.11909/j.issn.1671-5411.2022.05.003 [doi] AB - BACKGROUND: There is scarce data on the long-term mortality and associated prognostic factors in patients with dilated cardiomyopathy (DCM). The study aimed to investigate the all-cause mortality up to 15 years (mean 7.9 +/- 5.7 years) in such patients, and the independent prognostic factors influencing their long-term mortality. METHODS: One hundred and sixty-six consecutive patients with DCM were prospectively enrolled from 2002 to 2003. The mean age of patients was 59.5 +/- 10.4 years, and approximately 57% were male. They were followed up by telephone or outpatient visit at least every three months until 2019 or all-cause death occurred. Predictors of mortality were identified using multivariate logistic regression analysis. RESULTS: During the 15 years of follow-up, five patients were lost to follow-up, and the complete data records of 161 patients were included in the analysis. Patients were treated with angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-receptor blocker (ARB), beta-blockers, mineralocorticoid receptor antagonist (MRA), diuretics and digitalis from 2002 to 2004, and maintained at the maximum tolerated doses between 2004 and 2019. Our safety targets to maintain heart rate and blood pressure at 60-80 beats/min and 90-120/60-80 mmHg, respectively. All-cause mortality in the first five years was 55.9%. The independent risk factors for the 5-year mortality were age >/= 70 years old (OR = 5.45, P = 0.006), systolic blood pressure (SBP) > 120 mmHg (OR = 3.63, P = 0.004), 6-minute walk distance (6MWD) < 450 m (OR = 3.84, P = 0.001). 15-year all-cause mortality was 65.8%. The independent risk factors for 15-year mortality were age >/= 70 years old (OR = 16.07, P = 0.009), LVEF 120 mmHg (OR = 9.56, P < 0.001). CONCLUSIONS: This study was the first to demonstrate the 15-year survival rate of 34% in DCM patients. The DCM patients' first five-year all-cause mortality decreased significantly after continuous standardized treatment and intensive management. The mortality then plateaued in the following 10 years. Age >/= 70 years, LVEF 120 mmHg were independent predictors of 15-year all-cause mortality. CI - Copyright and License information: Journal of Geriatric Cardiology 2022. FAU - Xu, Xiao-Rong AU - Xu XR AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Han, Meng-Meng AU - Han MM AD - Intensive Care Units, Beijing Longfu Hospital, Beijing, China. FAU - Yang, Yi-Zhen AU - Yang YZ AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Wang, Xin AU - Wang X AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Hou, Dong-Yan AU - Hou DY AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Meng, Xian-Chen AU - Meng XC AD - Statistics Department, Information Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Wang, Hua AU - Wang H AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Zhao, Wen-Shu AU - Zhao WS AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Zhang, Lin AU - Zhang L AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Xu, Lin AU - Xu L AD - Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. LA - eng PT - Journal Article PL - China TA - J Geriatr Cardiol JT - Journal of geriatric cardiology : JGC JID - 101237881 PMC - PMC9170907 EDAT- 2022/06/21 06:00 MHDA- 2022/06/21 06:01 PMCR- 2022/05/28 CRDT- 2022/06/20 04:02 PHST- 2022/06/20 04:02 [entrez] PHST- 2022/06/21 06:00 [pubmed] PHST- 2022/06/21 06:01 [medline] PHST- 2022/05/28 00:00 [pmc-release] AID - jgc-19-5-335 [pii] AID - 10.11909/j.issn.1671-5411.2022.05.003 [doi] PST - ppublish SO - J Geriatr Cardiol. 2022 May 28;19(5):335-342. doi: 10.11909/j.issn.1671-5411.2022.05.003.