Epidemiology and outcomes of peripartum cardiomyopathy in the United States: findings from the Nationwide Inpatient Sample.
Publication/Presentation Date
10-1-2016
Abstract
AIMS: Peripartum cardiomyopathy (PPCM) is defined as systolic heart failure within the last month of pregnancy or 5 months after delivery in the absence of any identifiable cause of heart failure. We aimed to investigate the prevalence of PPCM and predictors of in-hospital mortality in patients with PPCM.
METHODS: We analyzed patients with diagnosis of PPCM from the Nationwide Inpatient Sample database using the Ninth Revision of International Classification of Diseases (ICD-9) from 2009 to 2010. We categorized PPCM (n = 4871) into three groups of presentation based on their ICD-9 codes: antepartum (674.53; n = 189), peripartum (674.51, 674.52; n = 887) and postpartum (674.54; n = 3741).
RESULTS: PPCM was more common in African-Americans (43.9%) as compared with white (40.8%), Hispanic (8.7%) and Asian (2.7%) women. Hypertensive disorders were classified as pre-existing hypertension (31.6%), gestational hypertension (3.7%), preeclampsia (9.9%), eclampsia (2.4%) and preeclampsia/eclampsia superimposed on hypertension (3.1%). Among different ethnicities, pre-existing hypertension (1 : 2.3) and diabetes (1 : 10.4) were more prevalent in African-Americans, whereas preeclampsia (1 : 4.3) and premature labor (1 : 5.4) were more common in Asians. In-hospital mortality rate was 1.8%, with 2.1% in the postpartum and 0.5% in the peripartum group. Asians had the highest mortality (8.3%). In multimodel regression analysis, Asians [odds ratio (OR) 9.68, 95% confidence interval (CI) 1.11-83.9, P = 0.03] and length of stay (OR 1.06, 95% CI 1.03-1.10, P < 0.01) were associated with increased mortality, whereas white women were associated with reduced mortality (OR 0.10, 95% CI 0.02-0.59, P = 0.01).
CONCLUSION: Although PPCM was prevalent in African-Americans, Asians had higher in-hospital mortality, increased prevalence of preeclampsia and premature labor. Also, mortality rate was significantly higher in the postpartum group.
Volume
17
Issue
10
First Page
756
Last Page
761
ISSN
1558-2035
Published In/Presented At
Krishnamoorthy, P., Garg, J., Palaniswamy, C., Pandey, A., Ahmad, H., Frishman, W. H., & Lanier, G. (2016). Epidemiology and outcomes of peripartum cardiomyopathy in the United States: findings from the Nationwide Inpatient Sample. Journal of cardiovascular medicine (Hagerstown, Md.), 17(10), 756–761. https://doi.org/10.2459/JCM.0000000000000222
Disciplines
Medicine and Health Sciences
PubMedID
25943626
Department(s)
Department of Medicine, Fellows and Residents
Document Type
Article