Prognostic factors for adverse events in the follow-up of patient with dilated cardiomyopathy
Keywords:
atrial fibrillation, prognostic factorsAbstract
Introduction: Numerous factors are associated with major adverse cardiac events in patients with dilated cardiomyopathy. Identifying these factors allows for improved risk stratification.
Objective: Determine the prognostic factors of major adverse cardiac events in the follow-up of patients with dilated cardiomyopathy.
Methodology: Observational, descriptive, longitudinal, prospective study in 50 patients with dilated cardiomyopathy in the cardiology service of Dr. Carlos J. Finlay Hospital between 2021 and 2024, follow-up was carried out for one year after discharge and cardiac death, readmissions for heart failure, malignant ventricular arrhythmias and all combined were monitored. Survival curves were created using the Kaplan-Meier method and prognostic factors for adverse events were determined using Cox regression (Sex, Age ≥ 65 years, Obesity, LVEF ≤ 32%, LVDD ≥ 68 mm, atrial fibrillation, advanced functional class).
Results: The mean follow-up was 11.8 ± 1.6 months, 58% of patients experienced events, with survival free of cardiac death (76%), readmission for heart failure (78%) and malignant ventricular arrhythmias (94%). Multivariate predictors were left ventricular ejection fraction ≤ 32% (p-0.042; 95% CI: 2,122-2,445), left ventricular diastolic diameter ≥ 68 mm (p-0.001; 95% CI: 2,421-5,500), advanced functional class (p-0.048; 95% CI: 2,140-2,556) and atrial fibrillation (p-0.035; 95% CI: 10,914-22,154).
Conclusions: In patients with dilated cardiomyopathy, cardiac death was the most frequently reported event. Left ventricular anatomical and functional variables and the presence of atrial fibrillation were associated with worse clinical outcome at one-year follow-up.
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