No abstract

Background: Past data suggest ischemic cardiomyopathy (ICM) is associated with worse prognosis when compared to non-ischemic cardiomyopathy(NICM). With advances in heart failure management, this relationship deserves a fresh look. We hypothesize that all cause mortality from NICM is lower when compared to ICM over five year period. Methods: We retrospectively studied consecutive heart failure patients with left ventricular ejection fraction(EF) less than 35% admitted to Einstein Medical Center Philadelphia between 01/01/2007 to 12/31/2007. Data pertaining to patient demographics and clinical characteristics were obtained. All cause mortality was obtained at 5 years using hazard ratio to account for time to event. Results: The final cohort consisted of 360 patients of which 63%(224 of 360) had NICM. Mean age was 61±16 years for NICM and 66±11 yrs for ICM. African Americans constituted 83%(185 of 224) of NICM and 59%(80 of 136) of ICM. The clinical characteristics are as shown in the table. There were 160 deaths over the follow up period. Age, CKD, dyslipidemia and EF were significant predictors of mortality. ICM cohort had 81 deaths out of 136(60%) as compared to 85 out of 185((39%) in NICM over the follow up period. However, when adjusted for age, DM, CKD and days of follow-up, there was no statistically significant difference in mortality between the two groups over the five year follow up period. Conclusions: In this study, there was no significant mortality difference between ICM and NICM. We also found that despite advances in heart failure management in the last two decades, in clinical practice they are under-utilized.