BARRIERS TO CARDIAC TRANSPLANTATION IN IDIOPATHIC DILATED CARDIOMYOPATHY - THE WASHINGTON, DC, DILATED CARDIOMYOPATHY STUDY

Although cardiac transplantation offers prolonged survival and improve d quality of life to patients with end-stage heart failure, many patie nts with idiopathic dilated cardiomyopathy do not undergo this procedu re. Possible barriers to cardiac transplantation were examined among 1 38 patients with idiopathic dilated cardiomyopathy from five hospitals in Washington, DC. Patients underwent follow-up For approximately 5 y ears. The patients or a close family member were interviewed at baseli ne about socioeconomic factors and medical history. The patients or th eir next-of-kin were recontacted at 1-year intervals to determine pati ents' vital status and to obtain information about cardiac transplanta tion. Overall, the cumulative survival at 12 and 60 months was 75.8% a nd 37.3%, respectively. Only 3.6% (5 of 138) of the patients underwent cardiac transplantation, and 19 (13.8%) patients had been placed on a waiting list for a heart transplant. Black race and nonmarried status were inversely associated with cardiac transplantation. Factors assoc iated with not having been placed on a waiting list included older age , lower income, and lack of private health insurance. Black race was f ound to be significantly, but inversely associated with cardiac transp lantation while older age was inversely associated with having been pl aced on a waiting list after adjusting For sex, race, education, and p rivate insurance. These findings suggest that black patients with idio pathic dilated cardiomyopathy are less likely to undergo cardiac trans plantation.