Publication: Impact of guideline-recommended versus non-guideline-recommended β-blocker and Doppler echocardiographic parameters on 1-year mortality in Thai ischemic cardiomyopathy patients: A prospective multicenter registry
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Issued Date
2020-01-09
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14712261
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2-s2.0-85077682202
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC cardiovascular disorders. Vol.20, No.1 (2020), 8
Suggested Citation
Nattawut Wongpraparut, Sarawut Siwamogsatham, Tomorn Thongsri, Pornchai Ngamjanyaporn, Arintaya Phrommintikul, Kompoj Jirajarus, Tarinee Tangcharoen, Kid Bhumimuang, Pinij Kaewsuwanna, Rungroj Krittayaphong, Rungtiwa Pongakasira, Harvey D. White Impact of guideline-recommended versus non-guideline-recommended β-blocker and Doppler echocardiographic parameters on 1-year mortality in Thai ischemic cardiomyopathy patients: A prospective multicenter registry. BMC cardiovascular disorders. Vol.20, No.1 (2020), 8. doi:10.1186/s12872-019-01311-4 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/49639
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Title
Impact of guideline-recommended versus non-guideline-recommended β-blocker and Doppler echocardiographic parameters on 1-year mortality in Thai ischemic cardiomyopathy patients: A prospective multicenter registry
Other Contributor(s)
Chonburi Regional Hospital
Chulalongkorn University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Thammasat University
Maharaj Nakhon Ratchasima Hospital
Auckland City Hospital
Buddhachinaraj Hospital
Faculty of Medicine, Siriraj Hospital, Mahidol University
Chiang Mai University
Surat Thani Hospital
Chulalongkorn University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Thammasat University
Maharaj Nakhon Ratchasima Hospital
Auckland City Hospital
Buddhachinaraj Hospital
Faculty of Medicine, Siriraj Hospital, Mahidol University
Chiang Mai University
Surat Thani Hospital
Abstract
BACKGROUND: Ischemic cardiomyopathy is a high-cost, resource-intensive public health burden that is associated with a 1-year mortality rate of about 16% in western population. Different in patient ethnicity and pattern of practice may impact the clinical outcome. We aim to determine 1-year mortality and to identify factors that significantly predicts 1-year mortality of Thai patients with ischemic cardiomyopathy. METHODS: This prospective multicenter registry enrolled consecutive Thai patients that were diagnosed with ischemic cardiomyopathy at 9 institutions located across Thailand. Patients with left ventricular function < 40% and one of the following criteria were included: 1) presence of epicardial coronary stenoses > 75% in the left main or proximal left anterior descending artery or coronary angiography, and/or two major epicardial coronary stenoses; 2) prior myocardial infarction; 3) prior revascularization by coronary artery bypass graft or percutaneous coronary intervention; or, 4) magnetic resonance imaging pattern compatible with ischemic cardiomyopathy. Baseline clinical characteristics, coronary and echocardiographic data were recorded. The 1-year clinical outcome was pre-specified. RESULTS: Four hundred and nineteen patients were enrolled. Thirty-nine patients (9.9%) had died at 1 year, with 27 experiencing cardiovascular death, and 12 experiencing non-cardiovascular death. A comparison between patients who were alive and patients who were dead at 1 year revealed lower baseline left ventricular ejection fraction (LVEF) (26.7 ± 7.6% vs 30.2 ± 7.8%; p = 0.021), higher left ventricular end-diastolic volume (LVEDV) (185.8 ± 73.2 ml vs 155.6 ± 64.2 ml; p = 0.014), shorter mitral valve deceleration time (142.9 ± 57.5 ml vs 182.4 ± 85.7 ml; p = 0.041), and lower use of statins (94.7% vs 99.7%; p = 0.029) among deceased patients. Patients receiving guideline-recommended β-blockers had lower mortality than patients receiving non-guideline-recommended β-blockers (8.1% vs 18.2%; p = 0.05). CONCLUSIONS: The results of this study revealed a 9.9% 1-year mortality rate among Thai ischemic cardiomyopathy patients. Doppler echocardiographic parameters significantly associated with 1-year mortality were LVEF, LVEDV, mitral E velocity, and mitral valve deceleration time. The use of non-guideline-recommended β-blockers rather than guideline recommended β-blockers were associated with increased with 1-year mortality. Guidelines recommended β-blockers should be preferred. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20190722002. Registered 22 July 2019. "Retrospectively registered".