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Predictors of mortality from idiopathic dilated cardiomyopathy in 356,222 men screened for the Multiple Risk Factor
S S Coughlin1, J D Neaton, A Sengupta
1Department of Biostatistics and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112.
Insights
Smoking, high diastolic blood pressure, and diabetes are key predictors of death from idiopathic dilated cardiomyopathy in men. Black race also showed an increased risk, highlighting factors for future prevention strategies.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Idiopathic dilated cardiomyopathy (IDCM) is a significant cause of heart failure.
- Identifying mortality predictors is crucial for developing effective preventive strategies.
Purpose of the Study:
- To investigate potential predictors of mortality in men with idiopathic dilated cardiomyopathy.
- To identify risk factors that can inform future public health interventions.
Main Methods:
- A cohort of 356,222 men from the Multiple Risk Factor Intervention Trial was studied.
- Vital status was tracked through 1986, with death certificates analyzed for cause.
- The proportional hazards model was used to assess relative risks of mortality.
Main Results:
- Significant mortality predictors included daily cigarette smoking, elevated diastolic blood pressure, and diabetes mellitus.
- Black race was associated with increased IDCM mortality risk.
- Serum cholesterol and income were not found to be associated with IDCM mortality.
Conclusions:
- Cigarette smoking, diastolic blood pressure, and diabetes are independent risk factors for IDCM mortality.
- Race may play a role in IDCM mortality risk.
- Findings can guide the development of targeted preventive programs for IDCM.
Abstract:
Possible predictors of mortality from idiopathic dilated cardiomyopathy were studied in 356,222 men who were screened as part of the Multiple Risk Factor Intervention Trial. The vital status of each member of this cohort was ascertained through 1986. Death certificates were obtained from state health departments and coded by a trained nosologist. Individuals with a history of myocardial infarction were excluded. A total of 206 deaths due to idiopathic dilated cardiomyopathy occurred in the cohort of 356,222 men after an average of 12 years of follow-up. The age-specific rates of mortality from idiopathic dilated cardiomyopathy increased from 0.10 per 10,000 person-years among men aged 35-39 years to 1.16 per 10,000 person-years among men aged 55-57 years. The proportional hazards model was used to obtain adjusted estimates of relative risks. Statistically significant, independent associations were observed with cigarettes smoked per day (p < 0.001), diastolic blood pressure (p < 0.001), and diabetes mellitus (relative risk (RR) = 2.97, p < 0.001). Black race was also associated with an increased risk of death from idiopathic dilated cardiomyopathy (RR = 1.59 and p = 0.045 without adjustment for income; RR = 1.58 and p = 0.058 with adjustment for income). No association was found with serum cholesterol or income. The information about possible risk factors obtained in this study may contribute to future preventive programs for idiopathic dilated cardiomyopathy.