Long-Term Prognosis of Dilated Cardiomyopathy Revisited An Improvement in Survival Over the Past 20 Years

• Published in: Circulation Journal Vol. 70; no. 4; pp. 376 - 383
• Main Authors: Matsumura, Yoshihisa, Takata, Jun, Kitaoka, Hiroaki, Kubo, Toru, Baba, Yuichi, Hoshikawa, Eri, Hamada, Tomoyuki, Okawa, Makoto, Hitomi, Nobuhiko, Sato, Kyoko, Yamasaki, Naohito, Yabe, Toshikazu, Furuno, Takashi, Nishinaga, Masanori, Doi, Yoshinori
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2006
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Anti-Arrhythmia Agents - therapeutic use; Cardiomyopathy, Dilated - diagnosis; Cardiomyopathy, Dilated - drug therapy; Cardiomyopathy, Dilated - mortality; Data Interpretation, Statistical; Death; Dilated cardiomyopathy; Female; Humans; Japan; Longitudinal Studies; Male; Middle Aged; Prognosis; Retrospective Studies; Survival Rate; Japan
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.70.376

Background Because of their favorable prognostic effects, angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB) and β 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. Methods and 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 β 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 β 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). Conclusion 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 β blockers and a declining use of antiarrhythmics. (Circ J 2006; 70: 376 - 383)