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

Area of Science:

• Cardiology
• Obstetrics
• Inpatient Medicine

Background:

• Peripartum cardiomyopathy (PPCM) is a rare form of heart failure.
• The co-occurrence and impact of coronary artery disease (CAD) in PPCM patients are not well understood.

Purpose of the Study:

• To determine the prevalence of CAD in patients admitted with PPCM.
• To analyze the association of CAD with in-hospital outcomes among PPCM patients.

Main Methods:

• Retrospective analysis of the National Inpatient Sample (NIS) database from January 2016 to December 2019.
• Inclusion of 4,730 patients admitted with PPCM.
• Multivariate analysis to assess the independent association of CAD with outcomes and mortality predictors.

Main Results:

• The prevalence of CAD among PPCM patients was 3.1% (146/4,730).
• CAD was independently associated with ST-segment elevation myocardial infarction (STEMI) (aOR: 58.457) and protective against preeclampsia (aOR: 0.351).
• Predictors of in-hospital mortality in PPCM included cardiogenic shock, non-ST elevation myocardial infarction (NSTEMI), chronic kidney disease, and atrial fibrillation.

Conclusions:

• CAD is present in a small but significant proportion of PPCM patients.
• CAD is associated with increased risk of STEMI but may offer protection against preeclampsia in this population.
• Identifying mortality predictors is crucial for managing PPCM patients.