The Impact of Coronary Artery Disease on Outcomes in Patients With Peripartum Cardiomyopathy.

ABSTRACT

Introduction The purpose of this study was to determine the prevalence of coronary artery disease (CAD) among patients admitted with peripartum cardiomyopathy (PPCM) as well as to analyze the independent association of CAD with in-hospital outcomes among PPCM patients. Methods Data were obtained from the National Inpatient Sample from January 2016 to December 2019. We assessed the independent association of CAD with outcomes in patients admitted with PPCM. Predictors of mortality in patients admitted with PPCM were also analyzed. Results There was a total of 4,730 patients with PPCM, 146 of whom had CAD (3.1%). Multivariate analysis demonstrated that CAD in patients with PPCM was independently associated with several outcomes, and, among them, ST-segment elevation myocardial infarction (STEMI) (adjusted odds ratio (aOR) 58.457, 95% CI 5.403-632.504, p= 0.001) was positively associated with CAD. CAD was found to be protective against preeclampsia (aOR 0.351, 95% CI 0.126-0.979, p = 0.045). Predictors of in-hospital mortality for patients with PPCM include cardiogenic shock (aOR 12.818, 95% CI 7.332-22.411, p = 0.001), non-ST elevation myocardial infarction (NSTEMI) (OR 3.429, 95% CI 1.43-8.22, p = 0.006), chronic kidney disease (OR 2.851, 95% CI 1.495-5.435, p = 0.001), and atrial fibrillation (OR 2.326, 95% CI 1.145-4.723, p = 0.020). Conclusion In a large cohort of patients admitted with PPCM, we found the prevalence of CAD to be 3.1%. CAD was associated with several adverse outcomes, including STEMI, but protective against preeclampsia.