Prognosis and prognostic factors in patients with idiopathic dilated cardiomyopathy in Japan.
BACKGROUND
There have been few large-scale nationwide studies investigating both the prognosis and the prognostic factors of idiopathic dilated cardiomyopathy (IDC). A predictive score that can be used in clinical practice has not been established.


RESULTS
A nationwide epidemiological study of the prognosis of IDC was conducted in 1999 among randomly selected hospitals in Japan, and 147 departments participated in the present 5-year follow-up survey. The vital status of 1,554 IDC patients was collected in 2004 using medical records and residence-based registers. The crude 5-year survival rate for those diagnosed in 1998 was 78.6%. Cox's regression model selected 5 independent predictors of mortality: male sex, higher age, higher New York Heart Association functional class, higher left ventricular diameter index, and lower left ventricular ejection fraction. A predictive score using these 5 variables effectively predicted prognosis; 5-year survival rates were 90.6% in patients with a score of 4 or less and 49.0% in patients with a score of 9 or 10.


CONCLUSIONS
This nationwide survey revealed the present prognostic status of IDC in Japan and 5 independent predictors of prognosis that can be used in clinical practice as a predictive score.
Miura
Katsuyuki
K
Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan. miura@kanazawa-med.ac.jp
Matsumori
Akira
A
Nasermoaddeli
Ali
A
Soyama
Yoshiyuki
Y
Morikawa
Yuko
Y
Sakurai
Masaru
M
Kitabatake
Akira
A
Nagai
Masaki
M
Inaba
Yutaka
Y
Nakagawa
Hideaki
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000401:mortality* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate