Please use this identifier to cite or link to this item: https://doi.org/10.1002/ejhf.1216
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dc.titleSex- and age-based differences in the natural history and outcome of dilated cardiomyopathy
dc.contributor.authorHalliday, B.P
dc.contributor.authorGulati, A
dc.contributor.authorAli, A
dc.contributor.authorNewsome, S
dc.contributor.authorLota, A
dc.contributor.authorTayal, U
dc.contributor.authorVassiliou, V.S
dc.contributor.authorArzanauskaite, M
dc.contributor.authorIzgi, C
dc.contributor.authorKrishnathasan, K
dc.contributor.authorSinghal, A
dc.contributor.authorChiew, K
dc.contributor.authorGregson, J
dc.contributor.authorFrenneaux, M.P
dc.contributor.authorCook, S.A
dc.contributor.authorPennell, D.J
dc.contributor.authorCollins, P
dc.contributor.authorCleland, J.G.F
dc.contributor.authorPrasad, S.K
dc.date.accessioned2020-10-22T07:20:14Z
dc.date.available2020-10-22T07:20:14Z
dc.date.issued2018
dc.identifier.citationHalliday, B.P, Gulati, A, Ali, A, Newsome, S, Lota, A, Tayal, U, Vassiliou, V.S, Arzanauskaite, M, Izgi, C, Krishnathasan, K, Singhal, A, Chiew, K, Gregson, J, Frenneaux, M.P, Cook, S.A, Pennell, D.J, Collins, P, Cleland, J.G.F, Prasad, S.K (2018). Sex- and age-based differences in the natural history and outcome of dilated cardiomyopathy. European Journal of Heart Failure 20 (10) : 1392-1400. ScholarBank@NUS Repository. https://doi.org/10.1002/ejhf.1216
dc.identifier.issn13889842
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/179021
dc.description.abstractAim: To evaluate the relationship between sex, age and outcome in dilated cardiomyopathy (DCM). Methods and 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 < 0.0001) compared to men. Women had smaller left ventricular end-diastolic volume (125 mL/m 2 vs. 135 mL/m 2 ; 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 [hazard ratio (HR) 0.61, 95% confidence interval (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 years: HR 1.36, 95% CI 1.20–1.55; P < 0.0001) and non-sudden death (per 10 years: 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. © 2018 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology
dc.publisherJohn Wiley and Sons Ltd
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceUnpaywall 20201031
dc.subjectgadolinium
dc.subjectadult
dc.subjectage
dc.subjectall cause mortality
dc.subjectArticle
dc.subjectcardiovascular mortality
dc.subjectcongestive cardiomyopathy
dc.subjectdisease association
dc.subjectdisease severity
dc.subjectfemale
dc.subjectfollow up
dc.subjectheart failure
dc.subjectheart left ventricle ejection fraction
dc.subjectheart left ventricle enddiastolic volume
dc.subjectheart left ventricle failure
dc.subjecthuman
dc.subjectincidence
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical history
dc.subjectoutcome assessment
dc.subjectphenotype
dc.subjectpriority journal
dc.subjectsex difference
dc.subjectsudden cardiac death
dc.subjectsurvival rate
dc.subjecttrend study
dc.subjectage
dc.subjectaged
dc.subjectcine magnetic resonance imaging
dc.subjectcongestive cardiomyopathy
dc.subjectheart left ventricle function
dc.subjectheart stroke volume
dc.subjectmiddle aged
dc.subjectpathophysiology
dc.subjectphysiology
dc.subjectprevalence
dc.subjectprocedures
dc.subjectprognosis
dc.subjectretrospective study
dc.subjectrisk factor
dc.subjectsex factor
dc.subjecttrends
dc.subjectUnited Kingdom
dc.subjectAdult
dc.subjectAge Factors
dc.subjectAged
dc.subjectCardiomyopathy, Dilated
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectMagnetic Resonance Imaging, Cine
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPrevalence
dc.subjectPrognosis
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectSex Factors
dc.subjectStroke Volume
dc.subjectSurvival Rate
dc.subjectUnited Kingdom
dc.subjectVentricular Function, Left
dc.typeArticle
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1002/ejhf.1216
dc.description.sourcetitleEuropean Journal of Heart Failure
dc.description.volume20
dc.description.issue10
dc.description.page1392-1400
dc.published.statePublished
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