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Prognostic potential of liver injury in patients with dilated cardiomyopathy: a retrospective study
Hai-Yan Wang1,2,3, Yuan Huang1,2,3, Xiao-Zhen Chen1,2,3
1Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No 6, Shuangyong Road, Nanning, 530021, Guangxi, China.
Insights
Liver injury (LI) in patients with dilated cardiomyopathy (DCM) is linked to significantly lower survival rates. Monitoring LI is crucial for better risk assessment and managing DCM patients.
Area of Science:
- Cardiology
- Hepatology
- Clinical Medicine
Background:
- Liver injury (LI) is a common comorbidity in patients with dilated cardiomyopathy (DCM).
- The prognostic significance of LI in DCM patients requires further clarification.
Purpose of the Study:
- To investigate the prognostic impact of liver injury on mortality in patients diagnosed with dilated cardiomyopathy.
Main Methods:
- Retrospective analysis of 523 DCM patients.
- LI defined by elevated liver enzymes (AST, ALT) or bilirubin levels.
- Propensity score matching (PSM) used to control for baseline covariates.
Main Results:
- Patients with LI exhibited a markedly lower survival rate compared to those without LI (44.6% vs. 73.8%, P < 0.001).
- This survival disparity persisted after PSM (44.6% vs. 64.1%, P = 0.019).
- LI was identified as a significant independent predictor of all-cause mortality in DCM patients (HR: 1.692, P = 0.003).
Conclusions:
- Liver injury is associated with adverse outcomes and increased mortality in DCM patients.
- Assessing LI can aid in the risk stratification and clinical management of individuals with DCM.
Background:
Liver injury (LI) has been frequently observed in patients with dilated cardiomyopathy (DCM), whereas its prognostic value remains blurry. We attempted to appraise the prognostic effect of LI in patients with DCM.
Methods:
This retrospective study included 523 patients with DCM. LI was defined as a threefold increase in aspartate transaminase (≥ 135 U/L) or alanine transaminase (≥ 180 U/L) or a twofold increase in total bilirubin (≥ 41 umol/L) during hospitalization. The population was segmented into non-liver injury (NLI) group and LI group based on liver function test data. To balance differences in covariates at baseline, 1:1 propensity score matching (PSM) was performed.
Results:
Patients with LI had lower survival rate, compared with those with NLI (44.6% vs. 73.8%, P < 0.001). Similar results were also found in age (age > 50, 39.6% vs. 70.9%, P < 0.001; age ≤ 50, 51.3% vs. 79.5%, P < 0.001) and gender stratified analysis (male, 46.2% vs. 74.4%, P < 0.001; female 35.7% vs. 72.0%, P = 0.001). After PSM, the survival rate of patients with LI remained lower than those with NLI (44.6% vs. 64.1%, P = 0.019). Multivariable Cox regression analysis manifested that LI (hazard ratio [HR]: 1.692, 95% confidence interval [CI] 1.194-2.398, P = 0.003; HR: 1.675, 95% CI 1.078-2.604, P = 0.022, respectively) showed potent predictive effect on all-cause mortality in patients with DCM, both before and after PSM.
Conclusions:
The occurrence of LI herald adverse outcomes in patients with DCM and attention to LI may be conducive to risk stratification and management.
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