Sunday, July 11, 2010

Dilated Cardiomyopathy - Treatment and Outcome

The impact of changing medical treatment on transplant-free survival in pediatric dilated cardiomyopathy. Paul F Kantor, Jonathan R. Abraham, Anne I. Dipchand, Lee N. Benson, Andrew N. Redington. JACC 2010;55:1377-84.

Single institution. Retrospective review of all patients over 30 years (1976-2005).
n-189, 44 died. 24 had transplant. 10 were lost to follow up. So, the study cohort n=111.
2-yr & 5-yr transplant-free survival = 63.6% and 56.3% respectively.

5-yr survival:
Digoxin only - 67.5%
Digoxin & ACEi - 57.2%
ACEi & BB - 58.5%

Multivariate analysis:
Low LVEF at presentation is associated with increased risk of death or transplantation.
End point was not influenced by time era or treatment strategy.

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