Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States: A nationwide population-based study

Dhaval Kolte, Sahil Khera, Wilbert S. Aronow, Chandrasekar Palaniswamy, Marjan Mujib, Chul Ahn, Diwakar Jain, Alan Gass, Ali Ahmed, Julio A. Panza, Gregg C. Fonarow

Research output: Contribution to journalArticle

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Abstract

Background: The reported incidence of peripartum cardiomyopathy (PPCM) in the United States varies widely. Furthermore, limited information is available on the temporal trends in incidence and outcomes of PPCM. Methods and Results: We queried the 2004-2011 Nationwide Inpatient Sample databases to identify all women aged 15 to 54 years with the diagnosis of PPCM. Temporal trends in incidence (per 10 000 live births), maternal major adverse events (MAE; defined as in-hospital mortality, cardiac arrest, heart transplant, mechanical circulatory support, acute pulmonary edema, thromboembolism, or implantable cardioverter defibrillator/permanent pacemaker implantation), cardiogenic shock, and mean length of stay were analyzed. From 2004 to 2011, we identified 34 219 women aged 15 to 54 years with PPCM. The overall PPCM rate was 10.3 per 10 000 (or 1 in 968) live births. PPCM incidence increased from 8.5 to 11.8 per 10 000 live births (P<inf>trend</inf> < 0.001) over the past 8 years. MAE occurred in 13.5% of patients. There was no temporal change in MAE rate, except a small increase in inhospital mortality and mechanical circulatory support (P<inf>trend</inf> < 0.05). Cardiogenic shock increased from 1.0% in 2004 to 4.0% in 2011 (P<inf>trend</inf> < 0.001). Mean length of stay decreased during the study period. Conclusion: From 2004 to 2011, the incidence of PPCM has increased in the United States. Maternal MAE rates overall have remained unchanged while cardiogenic shock, utilization of mechanical circulatory support, and in-hospital mortality have increased during the study period. Further study of the mechanisms underlying these adverse trends in the incidence and outcomes of PPCM are warranted.

Original languageEnglish (US)
Article number001056
JournalJournal of the American Heart Association
Volume3
Issue number3
DOIs
StatePublished - 2014

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Peripartum Period
Cardiomyopathies
Incidence
Population
Live Birth
Cardiogenic Shock
Hospital Mortality
Length of Stay
Mothers
Implantable Defibrillators
Pulmonary Edema
Heart Arrest
Pulmonary Embolism
Inpatients
Databases
Transplants

Keywords

  • Incidence
  • Major adverse events
  • Outcomes
  • Peripartum cardiomyopathy
  • Trends

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States : A nationwide population-based study. / Kolte, Dhaval; Khera, Sahil; Aronow, Wilbert S.; Palaniswamy, Chandrasekar; Mujib, Marjan; Ahn, Chul; Jain, Diwakar; Gass, Alan; Ahmed, Ali; Panza, Julio A.; Fonarow, Gregg C.

In: Journal of the American Heart Association, Vol. 3, No. 3, 001056, 2014.

Research output: Contribution to journalArticle

Kolte, D, Khera, S, Aronow, WS, Palaniswamy, C, Mujib, M, Ahn, C, Jain, D, Gass, A, Ahmed, A, Panza, JA & Fonarow, GC 2014, 'Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States: A nationwide population-based study', Journal of the American Heart Association, vol. 3, no. 3, 001056. https://doi.org/10.1161/JAHA.114.001056
Kolte, Dhaval ; Khera, Sahil ; Aronow, Wilbert S. ; Palaniswamy, Chandrasekar ; Mujib, Marjan ; Ahn, Chul ; Jain, Diwakar ; Gass, Alan ; Ahmed, Ali ; Panza, Julio A. ; Fonarow, Gregg C. / Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States : A nationwide population-based study. In: Journal of the American Heart Association. 2014 ; Vol. 3, No. 3.
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title = "Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States: A nationwide population-based study",
abstract = "Background: The reported incidence of peripartum cardiomyopathy (PPCM) in the United States varies widely. Furthermore, limited information is available on the temporal trends in incidence and outcomes of PPCM. Methods and Results: We queried the 2004-2011 Nationwide Inpatient Sample databases to identify all women aged 15 to 54 years with the diagnosis of PPCM. Temporal trends in incidence (per 10 000 live births), maternal major adverse events (MAE; defined as in-hospital mortality, cardiac arrest, heart transplant, mechanical circulatory support, acute pulmonary edema, thromboembolism, or implantable cardioverter defibrillator/permanent pacemaker implantation), cardiogenic shock, and mean length of stay were analyzed. From 2004 to 2011, we identified 34 219 women aged 15 to 54 years with PPCM. The overall PPCM rate was 10.3 per 10 000 (or 1 in 968) live births. PPCM incidence increased from 8.5 to 11.8 per 10 000 live births (Ptrend < 0.001) over the past 8 years. MAE occurred in 13.5{\%} of patients. There was no temporal change in MAE rate, except a small increase in inhospital mortality and mechanical circulatory support (Ptrend < 0.05). Cardiogenic shock increased from 1.0{\%} in 2004 to 4.0{\%} in 2011 (Ptrend < 0.001). Mean length of stay decreased during the study period. Conclusion: From 2004 to 2011, the incidence of PPCM has increased in the United States. Maternal MAE rates overall have remained unchanged while cardiogenic shock, utilization of mechanical circulatory support, and in-hospital mortality have increased during the study period. Further study of the mechanisms underlying these adverse trends in the incidence and outcomes of PPCM are warranted.",
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T1 - Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States

T2 - A nationwide population-based study

AU - Kolte, Dhaval

AU - Khera, Sahil

AU - Aronow, Wilbert S.

AU - Palaniswamy, Chandrasekar

AU - Mujib, Marjan

AU - Ahn, Chul

AU - Jain, Diwakar

AU - Gass, Alan

AU - Ahmed, Ali

AU - Panza, Julio A.

AU - Fonarow, Gregg C.

PY - 2014

Y1 - 2014

N2 - Background: The reported incidence of peripartum cardiomyopathy (PPCM) in the United States varies widely. Furthermore, limited information is available on the temporal trends in incidence and outcomes of PPCM. Methods and Results: We queried the 2004-2011 Nationwide Inpatient Sample databases to identify all women aged 15 to 54 years with the diagnosis of PPCM. Temporal trends in incidence (per 10 000 live births), maternal major adverse events (MAE; defined as in-hospital mortality, cardiac arrest, heart transplant, mechanical circulatory support, acute pulmonary edema, thromboembolism, or implantable cardioverter defibrillator/permanent pacemaker implantation), cardiogenic shock, and mean length of stay were analyzed. From 2004 to 2011, we identified 34 219 women aged 15 to 54 years with PPCM. The overall PPCM rate was 10.3 per 10 000 (or 1 in 968) live births. PPCM incidence increased from 8.5 to 11.8 per 10 000 live births (Ptrend < 0.001) over the past 8 years. MAE occurred in 13.5% of patients. There was no temporal change in MAE rate, except a small increase in inhospital mortality and mechanical circulatory support (Ptrend < 0.05). Cardiogenic shock increased from 1.0% in 2004 to 4.0% in 2011 (Ptrend < 0.001). Mean length of stay decreased during the study period. Conclusion: From 2004 to 2011, the incidence of PPCM has increased in the United States. Maternal MAE rates overall have remained unchanged while cardiogenic shock, utilization of mechanical circulatory support, and in-hospital mortality have increased during the study period. Further study of the mechanisms underlying these adverse trends in the incidence and outcomes of PPCM are warranted.

AB - Background: The reported incidence of peripartum cardiomyopathy (PPCM) in the United States varies widely. Furthermore, limited information is available on the temporal trends in incidence and outcomes of PPCM. Methods and Results: We queried the 2004-2011 Nationwide Inpatient Sample databases to identify all women aged 15 to 54 years with the diagnosis of PPCM. Temporal trends in incidence (per 10 000 live births), maternal major adverse events (MAE; defined as in-hospital mortality, cardiac arrest, heart transplant, mechanical circulatory support, acute pulmonary edema, thromboembolism, or implantable cardioverter defibrillator/permanent pacemaker implantation), cardiogenic shock, and mean length of stay were analyzed. From 2004 to 2011, we identified 34 219 women aged 15 to 54 years with PPCM. The overall PPCM rate was 10.3 per 10 000 (or 1 in 968) live births. PPCM incidence increased from 8.5 to 11.8 per 10 000 live births (Ptrend < 0.001) over the past 8 years. MAE occurred in 13.5% of patients. There was no temporal change in MAE rate, except a small increase in inhospital mortality and mechanical circulatory support (Ptrend < 0.05). Cardiogenic shock increased from 1.0% in 2004 to 4.0% in 2011 (Ptrend < 0.001). Mean length of stay decreased during the study period. Conclusion: From 2004 to 2011, the incidence of PPCM has increased in the United States. Maternal MAE rates overall have remained unchanged while cardiogenic shock, utilization of mechanical circulatory support, and in-hospital mortality have increased during the study period. Further study of the mechanisms underlying these adverse trends in the incidence and outcomes of PPCM are warranted.

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KW - Outcomes

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KW - Trends

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