Imperial College London
Alternate

ProfessorStuartCook

Faculty of Medicine, Institute of Clinical Sciences

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 3313 1346stuart.cook

 
 
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Location

 

RF 16Sydney StreetRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Halliday:2018:10.1002/ejhf.1216,
author = {Halliday, BP and Gulati, A and Ali, A and Newsome, S and Lota, A and Tayal, U and Vassiliou, V and Arzanauskaite, M and Izgi, C and Kirshnathasan, K and Singhal, A and Chiew, K and Gregson, J and Frenneaux, M and Cook, S and Pennell, D and Collins, P and Cleland, J and Prasad, S},
doi = {10.1002/ejhf.1216},
journal = {European Journal of Heart Failure},
pages = {1392--1400},
title = {Sex and age-based differences in the natural history and outcome of dilated cardiomyopathy},
url = {http://dx.doi.org/10.1002/ejhf.1216},
volume = {20},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Aims:  To evaluate the relationship between sex, age and outcome in dilated cardiomyopathy (DCM). Methods & Results: We used proportional hazard modelling to examine the association between sex, age and all-cause mortality in consecutive patients with DCM. Overall, 881 patients (290 women, median age 52 years) were followed for a median of 4.9 years.  Women were more likely to present with heart failure (64.0% vs 54.5%; p=0.007) and had more severe symptoms (p<0.001) compared to men. Women had smaller left ventricular end-diastolic volume (125ml/m2 vs 135ml/m2, p<0.001), higher left ventricular ejection fraction (40.2% vs 37.9%, p=0.019) and were less likely to have mid-wall late gadolinium enhancement (23.0% vs 38.9%, p<0.0001). During follow-up 149 (16.9%) patients died, including 41 (4.7%) who died suddenly. After adjustment, all-cause mortality (HR 0.61; 95%CI 0.41:0.92; p=0.018) was lower in women, with similar trends for cardiovascular (HR 0.60; 95%CI 0.35-1.05; p=0.07), non-sudden (HR 0.63; 95%CI 0.39-1.02; p=0.06) and sudden death (HR 0.70, 95%CI 0.30:1.63; p=0.41). All-cause mortality (per 10 yrs: HR 1.36, 95%CI 1.20-1.55; p<0.00001) and non-sudden death (per 10 yrs: HR 1.51, 95%CI 1.26 – 1.82; p<0.00001) increased with age. Cumulative incidence curves confirmed favourable outcomes, particularly in women and those <60 years. Increased all-cause mortality in patients >60 years of age was driven by non-sudden death. Conclusion:  Women with DCM have better survival compared to men, which may partly be due to less severe left ventricular dysfunction and a smaller scar burden.  There is increased mortality driven by non-sudden death in patients >60 years of age that is less marked in women. Outcomes with contemporary treatment were favourable, with a low incidence of sudden death.
AU  - Halliday,BP
AU  - Gulati,A
AU  - Ali,A
AU  - Newsome,S
AU  - Lota,A
AU  - Tayal,U
AU  - Vassiliou,V
AU  - Arzanauskaite,M
AU  - Izgi,C
AU  - Kirshnathasan,K
AU  - Singhal,A
AU  - Chiew,K
AU  - Gregson,J
AU  - Frenneaux,M
AU  - Cook,S
AU  - Pennell,D
AU  - Collins,P
AU  - Cleland,J
AU  - Prasad,S
DO  - 10.1002/ejhf.1216
EP  - 1400
PY  - 2018///
SN  - 1388-9842
SP  - 1392
TI  - Sex and age-based differences in the natural history and outcome of dilated cardiomyopathy
T2  - European Journal of Heart Failure
UR  - http://dx.doi.org/10.1002/ejhf.1216
UR  - http://hdl.handle.net/10044/1/59167
VL  - 20
ER  -
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