Sex Differences in Dilated Cardiomyopathy Prognosis

Area of Science:

• Cardiology
• Clinical Epidemiology
• Sex Differences in Medicine

Background:

• Dilated cardiomyopathy (DCM) is a prevalent heart condition with significant mortality.
• Prognostic sex differences in DCM patients are not well-established, creating uncertainty in clinical management.
• Understanding these differences is crucial for personalized patient care and risk stratification.

Purpose of the Study:

• To conduct a meta-analysis investigating sex-based differences in the prognosis of patients diagnosed with dilated cardiomyopathy.
• To provide evidence-based insights into whether male or female DCM patients experience poorer outcomes.
• To inform physicians and patients about potential sex-specific risks associated with DCM.

Main Methods:

• A systematic literature search was performed across PubMed, Cochrane, and EMBASE databases.
• Included were 5 cohort studies published up to February 16, 2020, encompassing 5,709 patients with DCM.
• Data on sex-specific prognostic outcomes, including all-cause mortality and sudden cardiac death (SCD), were analyzed.

Main Results:

• Male patients with DCM exhibited a significantly higher risk of all-cause mortality compared to females (HR: 1.61).
• This increased mortality risk in males was consistent across both short-term (<5 years) and long-term (≥5 years) follow-up periods.
• Males with DCM also faced elevated risks of sudden cardiac death (SCD) (HR: 1.80) and cardiovascular mortality (HR: 1.67) compared to females.

Conclusions:

• The meta-analysis provides strong evidence that males with dilated cardiomyopathy have a worse prognosis than females.
• Men with DCM are at increased risk for all-cause mortality, cardiovascular mortality, and sudden cardiac death.
• These findings highlight the importance of considering sex as a critical factor in the management and prognosis of dilated cardiomyopathy.