Comparison of dilated cardiomyopathy and coronary artery disease in patients with life-threatening ventricular arrhythmias: Differences in presentation and outcome in the AVID registry
Fa. Ehlert et al., Comparison of dilated cardiomyopathy and coronary artery disease in patients with life-threatening ventricular arrhythmias: Differences in presentation and outcome in the AVID registry, AM HEART J, 142(5), 2001, pp. 816-822
Citations number
16
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background The etiology of structural heart disease in patients with life-t
hreatening arrhythmias (ventricular tachycardia [VT]/ventricular fibrillati
on [VF]) may define clinical characteristics at presentation, may require t
hat different therapies be administered, and may cause different mortality
outcomes.
Methods In the Antiarrhythmics Versus Implantable Defibrillators (AVID) reg
istry, baseline clinical characteristics, treatments instituted, and ultima
te mortality outcomes from the National Death Index were obtained on 3117 p
atients seen at participating institutions with VT/VF, irrespective of part
icipation in the randomized trial. By use of these data, 2268 patients with
coronary artery disease (CAD) were compared with 334 patients with dilated
nonischemic cardiomyopathy (DCM).
Results The CAD group was 7 years older and had a higher percentage of male
s. DCM patients were more likely to be African American, have severely comp
romised left ventricular function (52% vs 39%), and have a history of conge
stive heart failure symptoms (62% vs 44%). Patients with CAD were more like
ly to be treated with beta -blockers and calcium channel blockers and less
likely to be treated with angiotensin-converting enzyme inhibitors. Patient
s with DCM were more likely to be treated with diuretics, warfarin, and an
implantable cardioverter defibrillator for VT/VF (54% vs 48% for CAD); the
use of other antiarrhythmic therapies did not differ between the 2 groups.
Two-year survival was not significantly different between the groups (76.6%
[95% CI 74.6%-78.7%] vs 78.2% [95% CI 73.6%-82.9%]).
Conclusions In AVID registry patients with VT/VF, demographic and clinical
characteristics were different between patients with CAD and those with DCM
. Despite these differences, overall survival was similar in these 2 groups
.