Long-term prognosis of dilated cardiomyopathy revisited: an improvement in survival over the past 20 years.
BACKGROUND
Because of their favorable prognostic effects, angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB) and beta blockers have become background therapy in dilated cardiomyopathy (DCM). However, there are few reports concerning the long-term prognosis of Japanese patients with DCM in relation to these treatments.


RESULTS
One hundred and fifty patients with DCM were divided into 2 groups: group A (n=46) (diagnosis: 1982-1989) and group B (n=104) (diagnosis: 1990-2002). During follow-up period of 6.9+/-4.8 years, 62 patients died and 1 patient had a heart transplant. The survival rate at 5 and 10 years was 60.9% and 34.8%, respectively, in group A patients, and 80.9% and 65.3%, respectively, in group B patients (p=0.0079). In group A patients, ACEI/ARB or beta blockers were less frequently used (p<0.0001), whereas antiarrhythmics (class Ia or Ib) were more often used (p<0.0001). The patients treated with ACEI/ARB and beta blockers showed a better survival rate than those without (p<0.0001). The patients with antiarrhythmics showed a worse survival rate than those without (p<0.0001).


CONCLUSIONS
The prognosis of Japanese patients with DCM has significantly improved over the past 20 years. This improvement may be explained partly through the increased use of ACEI/ARB and beta blockers and a declining use of antiarrhythmics.
Matsumura
Yoshihisa
Y
Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Nankoku-shi, Japan.
Takata
Jun
J
Kitaoka
Hiroaki
H
Kubo
Toru
T
Baba
Yuichi
Y
Hoshikawa
Eri
E
Hamada
Tomoyuki
T
Okawa
Makoto
M
Hitomi
Nobuhiko
N
Sato
Kyoko
K
Yamasaki
Naohito
N
Yabe
Toshikazu
T
Furuno
Takashi
T
Nishinaga
Masanori
M
Doi
Yoshinori
Y
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D003627:Data Interpretation, Statistical; D003643:Death; D005260:Female; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents