Recurrence of ventricular arrhythmias in patients with non-ischaemic dilated cardiomyopathy: evidence-based predictors.
BACKGROUND
Ventricular arrhythmia (VA) is the most frequent cause of sudden death among patients with non-ischaemic dilated cardiomyopathy (DCM).


OBJECTIVE
To identify the important VA risk factors in patients with DCM.


RESULTS
Eighty-five DCM patients (73 males, mean age 54 years) with DCM and implantable cardioverter defibrillators (ICD) were followed for 21+/-19 months after ICD implantation. The mean follow-up was 21 months. Data from 55 patients with VA recorded in the ICD memory and requiring ICD intervention during follow-up were compared with 30 patients without arrhythmia. Cox regression analysis identified the following univariate predictors of VA: alcoholic aetiology of DCM (0.05), diuretic treatment (0.003), history of cardiac arrest (0.03), right ventricular diastolic diameter (0.001). Both ACE inhibitor (ACEI) and statin treatments were associated with a tendency towards decreased risk of VA. Multivariate logistic analysis identified four predictors as significantly related to VA: alcoholic aetiology (HR 4.8, p=0.008), ACEI treatment (HR 0.4, p=0.01), diuretic treatment (HR 2.6, p=0.015), and statin treatment (HR 0.1, p=0.03).


CONCLUSIONS
The majority of patients with DCM and ICD have recurrences of VA. Alcoholic aetiology of DCM is associated with an increase in the incidence of arrhythmias. Treatment with ACEI and statins is associated with a reduction of arrhythmias.
Department of Cardiology, J. Brudziński Hospital, Gdynia, Poland.
Elzbieta
E
Dułak
Andrzej
A
Lubiński
Andrzej
A
Bissinger
Andrzej
A
Przybylski
Maciej
M
Sterlinski
Artur
A
Filipecki
Anna
A
Pazdyga
Agnieszka
A
Zienciuk
Maciej
M
Kempa
Tomasz
T
Królak
Hanna
H
Szwed
Maria
M
Trusz-Gluza
Włodzimierz
W
Kargul
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D002311:Cardiomyopathy, Dilated / Q000401:mortality* / Q000628:therapy; D015984:Causality; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D014693:Ventricular Fibrillation / Q000401:mortality* / Q000628:therapy
D000319:Adrenergic beta-Antagonists