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Age-related disparities in complications among women with peripartum cardiomyopathy
Nitish Behary Paray1, Kamleshun Ramphul2, Sarah Mackenzie Picker3
1Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom.
Insights
Older women with peripartum cardiomyopathy (PPCM) face higher risks of stroke but lower risks of cardiogenic shock. This study highlights age-related differences in PPCM complications, informing clinical management strategies.
Area of Science:
- Cardiology
- Obstetrics
- Public Health
Background:
- Peripartum cardiomyopathy (PPCM) is a serious condition with rising global incidence.
- The exact causes of PPCM remain unknown, necessitating further research into risk factors and outcomes.
- Understanding age-related differences in PPCM is crucial for effective patient management.
Purpose of the Study:
- To investigate the differences in in-hospital complications and outcomes for peripartum cardiomyopathy patients based on age.
- To compare the incidence of cardiovascular risk factors and adverse events between younger (15-29 years) and older (30-40 years) PPCM cohorts.
Main Methods:
- Utilized data from the 2016-2020 National Inpatient Sample for hospitalized females diagnosed with PPCM.
- Stratified patients into two age groups: 15-29 years and 30-40 years.
- Employed multivariable regression analysis to compare in-hospital complications between the age cohorts.
Main Results:
- The study included 20,520 PPCM patients; 57.3% were aged 30-40 years.
- Women aged 30-40 had higher prevalence of smoking, obesity, hypertension, and diabetes.
- Older women showed increased odds of acute ischemic stroke (aOR 1.354) but reduced odds of cardiogenic shock (aOR 0.787) compared to younger women.
Conclusions:
- Peripartum cardiomyopathy management requires careful consideration of age-related risk profiles.
- Patients aged 30-40 with PPCM experienced a higher likelihood of acute ischemic stroke and a lower likelihood of cardiogenic shock.
- No significant age-based differences were observed in acute kidney injury, acute pulmonary edema, or in-hospital mortality.
Introduction:
While the exact pathogenesis of peripartum cardiomyopathy, a potentially life-threatening condition, is still unknown, its incidence is rising globally. We sought to understand the differences in outcomes and complications based on age.
Methods:
Records from the 2016-2020 National Inpatient Sample were used for our study. The sample consisted of females diagnosed with peripartum cardiomyopathy that required hospitalization care. They were divided into two age-based cohorts: 15-29 years and 30-40 years. We evaluated differences in in-hospital complications between the two groups using multivariable regression.
Results:
The analysis consisted of 20520 females diagnosed with peripartum cardiomyopathy, of whom 57.3 % were in the 30-40 years cohort and 42.7 % in the 15-29 years group. The prevalence of cardiovascular risk factors such as smoking, obesity, hypertension, diabetes and lipid disorder was higher among women aged 30-40 years (p < 0.01). These patients also demonstrated higher odds of reporting acute ischemic stroke (aOR 1.354, 95 % CI 1.038-1.767, p = 0.026) while having a reduced risk of cardiogenic shock (aOR 0.787, 95 % CI 0.688-0.901, p < 0.01) as compared to those aged 15-29 years during their hospitalisation with PPCM. No statistically significant differences were noted for events of acute kidney injury (aOR 1.074, 95 % CI 0.976-1.182, p = 0.143), acute pulmonary oedema (aOR 1.147, 95 % CI 0.988-1.332, p = 0.071) or in-hospital mortality (aOR 0.978, 95 % CI 0.742-1.290, p = 0.877).
Conclusion:
Peripartum cardiomyopathy is a serious condition that requires appropriate care and management. Our study linked cases of ages 30-40 years with increased odds of acute ischemic stroke but lower odds of cardiogenic shock.
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