Title: Recent Trends in Clinical Outcomes and Prognostic Factors in Patients with Dilated Cardiomyopathy-The CHART Studies
Abstract: We have conducted the CHART-1 (2000-2005, N=1,278) and CHART-2 (2006-present, N=10,219) studies, which enables us to elucidate the recent trends in the management of dilated cardiomyopathy (DCM). We compared 306 and 710 DCM patients in CHART-1 and CHART-2, respectively. As compared with CHART-1, 3-year mortality was significantly improved in CHART-2 (14% vs. 9%, P=0.01) along with penetration of evidence-based medicine including β-blockers (48% vs. 79%, P<0.01). Especially, the improvement was noted in patients treated with β-blockers and those with LVEF>40% (Figure). Indeed, the use of β-blockers (adjusted HR 0.51, P=0.02) and LVEF>40% (adjusted HR 0.25, P<0.01) were significant prognostic factors in CHART-2 but not in CHART-1. Prognosis of DCM patients has been recently improved in Japan, especially in those with β-blocker treatment or relatively preserved LVEF.