TY - JOUR
T1 - Improved long-term prognosis of dilated cardiomyopathy with implementation of evidenced-based medication
T2 - Report from the CHART studies
AU - CHART-2
AU - Ushigome, Ryoichi
AU - Sakata, Yasuhiko
AU - Nochioka, Kotaro
AU - Miyata, Satoshi
AU - Miura, Masanobu
AU - Tadaki, Soichiro
AU - Yamauchi, Takeshi
AU - Sato, Kenjiro
AU - Onose, Takeo
AU - Tsuji, Kanako
AU - Abe, Ruri
AU - Takahashi, Jun
AU - Shimokawa, Hiroaki
AU - Goto, Toshikazu
AU - Nozaki, Eiji
AU - Hiramoto, Tetsuya
AU - Fukuchi, Mitsumasa
AU - Inoue, Kanichi
AU - Kato, Atsushi
AU - Sugi, Masafumi
AU - Ohe, Masatoshi
AU - Shinozaki, Tsuyoshi
AU - Horiguchi, Satoru
AU - Kato, Hiroshi
AU - Ogata, Masahiko
AU - Sato, Shoichi
AU - Oyama, Shigeto
AU - Nakamura, Akihiro
AU - Fukui, Shigehumi
AU - Aizawa, Kentaro
AU - Kikuchi, Yoku
AU - Nakayama, Masaharu
AU - Fukuda, Koji
AU - Sugimura, Koichiro
AU - Sato, Kimio
AU - Matsumoto, Yasuharu
AU - Nakano, Makoto
AU - Shiroto, Takashi
AU - Yamamoto, Hiroaki
AU - Aoki, Tatsuo
AU - Hao, Kiyotaka
AU - Tatebe, Shunsuke
AU - Yamamoto, Saori
AU - Suzuki, Hideaki
AU - Nishimiya, Kensuke
AU - Yaoita, Nobuhiro
AU - Hasebe, Yuhi
AU - Saga, Chiharu
AU - Ikeno, Yasuko
AU - Suzuki, Tomoyuki
N1 - Publisher Copyright:
© 2015 Japanese Circulation Society. All rights reserved.
PY - 2015/5/11
Y1 - 2015/5/11
N2 - Background: Recent trends in the clinical characteristics, management and prognosis of dilated cardiomyopathy (DCM) remain to be examined in Japan. Methods and Results: We compared 306 and 710 DCM patients in the Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-1 (2000–2005, n=1,278) and the CHART-2 (2006–present, n=10,219) Studies, respectively. Between the 2 groups of DCM patients, there were no significant differences in baseline characteristics. The prevalence of hypertension, dyslipidemia and diabetes mellitus were all significantly increased from the CHART-1 to the CHART-2 Study. The use of β-blockers and aldosterone antagonists was significantly increased, while that of loop diuretics and digitalis was significantly decreased in the CHART-2 Study. The 3-year mortality rate was significantly improved from 14% in the CHART-1 to 9% in the CHART-2 Study (adjusted HR, 0.60; 95% CI: 0.49–0.81; P=0.001). In particular, 3-year incidence of cardiovascular death was significantly decreased (adjusted HR, 0.26; 95% CI: 0.14–0.50, P<0.001), while that of HF admission was not (adjusted HR, 0.90; 95% CI: 0.59–1.37, P=0.632). The prognostic improvement was noted in patients with BNP <220 pg/ml, LVEF>40%, β-blocker use and aldosterone antagonist use. Conclusions: Long-term prognosis of DCM patients has been improved, along with the implementation of evidencebased medication in Japan.
AB - Background: Recent trends in the clinical characteristics, management and prognosis of dilated cardiomyopathy (DCM) remain to be examined in Japan. Methods and Results: We compared 306 and 710 DCM patients in the Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-1 (2000–2005, n=1,278) and the CHART-2 (2006–present, n=10,219) Studies, respectively. Between the 2 groups of DCM patients, there were no significant differences in baseline characteristics. The prevalence of hypertension, dyslipidemia and diabetes mellitus were all significantly increased from the CHART-1 to the CHART-2 Study. The use of β-blockers and aldosterone antagonists was significantly increased, while that of loop diuretics and digitalis was significantly decreased in the CHART-2 Study. The 3-year mortality rate was significantly improved from 14% in the CHART-1 to 9% in the CHART-2 Study (adjusted HR, 0.60; 95% CI: 0.49–0.81; P=0.001). In particular, 3-year incidence of cardiovascular death was significantly decreased (adjusted HR, 0.26; 95% CI: 0.14–0.50, P<0.001), while that of HF admission was not (adjusted HR, 0.90; 95% CI: 0.59–1.37, P=0.632). The prognostic improvement was noted in patients with BNP <220 pg/ml, LVEF>40%, β-blocker use and aldosterone antagonist use. Conclusions: Long-term prognosis of DCM patients has been improved, along with the implementation of evidencebased medication in Japan.
KW - Beta-blocker
KW - Dilated cardiomyopathy
KW - Lifestyle disease
KW - Prognosis
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U2 - 10.1253/circj.CJ-14-0939
DO - 10.1253/circj.CJ-14-0939
M3 - Article
C2 - 25833177
AN - SCOPUS:84991358697
VL - 79
SP - 1332
EP - 1341
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 6
ER -