ABSTRACT
Peripartum cardiomyopathy (PPCM) is a rare but significant cause of new-onset heart failure (HF) during the peri- and post-partum periods. Advances in GDMT for HF with reduced ventricular function have led to substantial improvements in survival and quality of life, yet few studies examine the longitudinal care received by patients with PPCM. The aim of this research is to address this gap by retrospectively characterizing patients with PPCM across a multihospital health system and investigating the frequency of cardiology and HF specialty referrals. Understanding whether surveillance and medical management differ among patients referred to HF will help to underscore the importance of referring patients with PPCM to HF specialists for optimal care.
Subject(s)
Cardiomyopathies , Heart Failure , Peripartum Period , Pregnancy Complications, Cardiovascular , Referral and Consultation , Humans , Female , Heart Failure/therapy , Heart Failure/epidemiology , Heart Failure/diagnosis , Cardiomyopathies/therapy , Cardiomyopathies/epidemiology , Cardiomyopathies/diagnosis , Adult , Retrospective Studies , Pregnancy , Pregnancy Complications, Cardiovascular/therapy , Pregnancy Complications, Cardiovascular/epidemiology , Pregnancy Complications, Cardiovascular/diagnosis , Puerperal Disorders/therapy , Puerperal Disorders/epidemiology , Puerperal Disorders/diagnosisABSTRACT
BACKGROUND: Patients with pre-existing heart failure (HF) are likely at higher risk for adverse outcomes in coronavirus disease-2019 (COVID-19), but data on this population are sparse. OBJECTIVES: This study described the clinical profile and associated outcomes among patients with HF hospitalized with COVID-19. METHODS: This study conducted a retrospective analysis of 6,439 patients admitted for COVID-19 at 1 of 5 Mount Sinai Health System hospitals in New York City between February 27 and June 26, 2020. Clinical characteristics and outcomes (length of stay, need for intensive care unit, mechanical ventilation, and in-hospital mortality) were captured from electronic health records. For patients identified as having a history of HF by International Classification of Diseases-9th and/or 10th Revisions codes, manual chart abstraction informed etiology, functional class, and left ventricular ejection fraction (LVEF). RESULTS: Mean age was 63.5 years, and 45% were women. Compared with patients without HF, those with previous HF experienced longer length of stay (8 days vs. 6 days; p < 0.001), increased risk of mechanical ventilation (22.8% vs. 11.9%; adjusted odds ratio: 3.64; 95% confidence interval: 2.56 to 5.16; p < 0.001), and mortality (40.0% vs. 24.9%; adjusted odds ratio: 1.88; 95% confidence interval: 1.27 to 2.78; p = 0.002). Outcomes among patients with HF were similar, regardless of LVEF or renin-angiotensin-aldosterone inhibitor use. CONCLUSIONS: History of HF was associated with higher risk of mechanical ventilation and mortality among patients hospitalized for COVID-19, regardless of LVEF.
