The usefulness of age and sex to predict all-cause mortality in patients with dilated cardiomyopathy: a single-center cohort study

Figures & data

Figure 1 Flowchart for participants in the present study.

Abbreviations: DCM, dilated cardiomyopathy; Hb, hemoglobin.

Table 1 Patient characteristics categorized by age and sex

Variables	All patients (n=1,142)	Age <60 years (n=811)	Age ≥60 years (n=331)	P-value	Male (n=836)	Female (n=306)	P-value
History
Disease duration (years)	2 (0.5–6)	2 (0.45–5)	4 (1–9)	<0.001	2 (0.45–6)	3.5 (1–8)	<0.001
Arterial hypertension, n (%)	303 (26.5)	204 (25.2)	99 (29.9)	0.099	244 (26.8)	79 (25.8)	0.740
Diabetes mellitus, n (%)	163 (14.3)	110 (13.6)	53 (16.0)	0.283	108 (12.9)	55 (18.0)	0.031
Stroke, n (%)	51 (4.5)	26 (3.2)	25 (7.6)	0.001	37 (4.4)	14 (4.6)	0.914
Atrial fibrillation, n (%)	263 (23.0)	159 (19.6)	104 (31.4)	<0.001	207 (24.8)	56 (18.3)	0.022
Ventricular premature beats, n (%)	388 (34.0)	263 (32.4)	125 (37.8)	0.215	289 (34.6)	99 (32.4)	0.484
Ventricular tachycardia, n (%)	222 (19.4)	158 (19.5)	64 (19.3)	0.955	166 (19.9)	56 (18.3)	0.556
Smoking, n (%)	366 (32.7)	397 (49.0)	128 (38.7)	0.002	505 (60.4)	20 (6.5)	<0.001
Alcohol use, n (%)	229 (20.5)	286 (35.3)	85 (25.7)	0.002	364 (43.5)	7 (2.3)	<0.001
NYHA class III and IV, n (%)	836 (73.2)	581 (71.6)	255 (77.0)	0.062	607 (72.6)	229 (74.8)	0.451
Vital signs at admission
SBP (mmHg)	113.1±17.7	111.7±17.8	116.5±16.8	<0.001	113.1±17.7	112.9±17.6	0.827
DBP (mmHg)	72.5±12.6	72.7±12.8	71.8±12.0	0.272	72.9±12.6	71.1±12.6	0.031
Heart rate, beat/min	80.9±17.5	82.4±17.7	77.4±16.7	<0.001	81.3±17.9	80.0±16.5	0.269
Laboratory values at admission
AST (IU/L)	26 (20–35)	27 (20–37)	23 (19–32)	0.081	26 (20–36)	24 (19–33)	0.797
ALT (IU/L)	28 (19–45)	31 (21–48)	23 (16–35)	0.019	31 (21–48)	22.5 (17–33)	0.132
TB (mmol/L)	20.3 (15.1–30.675)	21.2 (15.3–22.4)	18.4 (14.9–27.25)	<0.001	21.5 (15.9–31.7)	17.8 (14–27.2)	<0.001
DB (mmol/L)	3.7 (2.5–6.5)	3.8 (2.5–7.0)	3.4 (2.4–5.925)	<0.001	3.9 (2.6–6.8)	3.2 (2.2–6.1)	0.049
Glucose (mmol/L)	5.62±1.84	5.49±1.70	5.94±2.12	<0.001	5.51±1.67	5.91±2.21	0.002
TG (mmol/L)	1.56±1.01	1.60±1.05	1.47±0.89	0.068	1.52±0.93	1.68±1.20	0.020
TC (mmol/L)	4.61±1.13	4.60±1.17	4.63±1.04	0.644	4.56±1.11	4.73±1.19	0.038
Creatinine (µmol/L)	92.7±35.1	90.1±32.4	99.0±40.2	<0.001	97.3±33.9	79.8±35.0	<0.001
BUN (µmol/L)	7.95±3.96	7.59±3.47	8.85±4.88	<0.001	8.13±3.95	7.44±3.97	0.011
Pro-NT BNP (fmol/mL)	2,012.2±1,573.9	1,440 (751.8–2,775.4)	1,809.6 (872.8–3,060.1)	0.020	1,560.4 (773.675–2,867.925)	1,485.65 (812.325–2,804.025)	0.849
Electrograph data
QRS duration (ms)	119.6±30.9	117.1±29.9	125.7±32.4	<0.001	119.1±30.1	121.0±32.9	0.344
QT (ms)	405.7±54.2	401.7±53.0	415.4±56.2	<0.001	405.1±54.1	407.4±54.8	0.528
P (ms)	107.5±21.6	109.0±21.2	103.2±22.4	0.001	108.8±22.1	104.1±20.1	0.005
PR (ms)	182.8±32.9	180.7±31.1	188.7±36.8	0.002	183.0±33.1	182.4±32.4	0.812
Echocardiography data
LVd (mm)	68.1±9.4	68.5±9.62	66.9±8.67	0.010	69.2±9.42	65.0±8.56	<0.001
LVEF (mm)	31.9±8.4	31.4±8.7	33.1±7.6	0.003	31.8±8.6	32.2±7.9	0.456
RV (mm)	23.6±5.4	24.1±5.6	22.4±4.6	<0.001	24.1±5.6	22.4±4.7	<0.001
LA (mm)	4.4.0±7.7	44.0±7.9	43.9±7.2	0.799	44.7±7.8	41.9±7.2	<0.001
Medications at admission
Diuretics, n (%)	1,081 (96.1)	762 (94.0)	319 (96.4)	0.099	792 (94.7)	289 (94.4)	0.846
ACEI/ARB, n (%)	969 (86.2)	686 (84.6)	283 (85.5)	0.005	708 (84.7)	261 (85.3)	0.801
Beta-blockers, n (%)	1,034 (91.9)	744 (91.7)	291 (87.9)	0.044	758 (90.7)	277 (90.5)	0.940
Digoxin, n (%)	921 (81.9)	666 (82.1)	255 (77.0)	0.049	676 (80.9)	245 (80.1)	0.763
Spironolactone, n (%)	1,036 (92.0)	737 (90.9)	229 (69.2)	0.000	758 (90.7)	278 (90.8)	0.926

Notes: 1) Data are expressed as the mean ± SD, medians (interquartile ranges), or as percentages. P-values were obtained from independent-sample t-tests. 2) A total of 24 patients lacked smoking status data, 25 patients lacked drinking status data, two lacked blood pressure data, 23 patients lacked electrocardiogram data, 47 patients lacked echocardiography data, 352 patients lacked NT-pro-BNP level data, 53 patients lacked fasting blood glucose level data, 35 patients lacked creatinine level data, 46 lacked BUN level data, 92 patients lacked triglyceride level data and total cholesterol level data, 78 lacked AST level data, 79 lacked ALT level data, 82 lacked TB level data, 83 lacked DB level data, and 17 lacked information about medications at admission. Bold data signifies P<0.05.

Abbreviations: NYHA, New York Heart Association; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; BUN, blood urea nitrogen; TG, triglyceride; BUN, blood urea nitrogen; TB, total bilirubin; DB, direct bilirubin; NT-pro-BNP, N-terminal fragment pro-brain natriuretic peptide; LA, left atrium; LVEF, left ventricular ejection fraction; ACEI, angiotension-converting enzyme inhibitor; ARB, angiotension receptor blocker; TC, total cholesterol; LVd, ventricular diameter; RV, left ventricle.

Figure 2 Kaplan–Meier survival curves for the elderly (age ≥60 years) and non-elderly patients (age <60 years) with dilated cardiomyopathy (DCM).

Notes: (A) shows the survival curves for the elderly and non-elderly DCM patients (log-rank χ²=2.604, P=0.107). (B) shows the survival curves for the male and female patients with DCM (log-rank χ²=0.707, P=0.400).

Figure 3 Kaplan–Meier survival curves for the elderly and non-elderly patients with DCM, stratified by sex ([A]: log-rank χ²=5.898, P=0.015 in male; [B]: log-rank χ²=1.062, P=0.303 in female).

Abbreviation: DCM, dilated cardiomyopathy.

Figure 4 Kaplan–Meier survival curves for the male and female patients with DCM, stratified by age ([A]: log-rank χ²=3.072, P=0.080 in non-elderly; [B]: log-rank χ²=2.725, P=0.189 in elderly).

Abbreviation: DCM, dilated cardiomyopathy.

Table 2 Cox regression of all-cause mortality in patients with DCM

Variable	Univariate analysis			Multivariate analysis
	HR	95% CI	P-value	HR	95% CI	P-value
Age	1.007	0.998–1.017	0.135	1.004	0.991–1.016	0.551
Sex	1.203	0.892–1.624	0.226	1.293	0.887–1.887	0.182
Ventricular premature beat	1.447	1.137–1.842	0.003	1.354	1.017–1.802	0.038
NYHA functional class	1.588	1.352–1.866	<0.001	1.223	0.990–1.511	0.062
Disease duration	1.027	1.010–1.044	0.001	1.012	0.990–1.035	0.291
Smoker	0.971	0.848–1.110	0.663	0.982	0.812–1.187	0.853
Drinker	0.891	0.765–1.039	0.140	0.947	0.768–1.168	0.612
Systolic blood pressure	0.982	0.975–0.989	<0.001	0.984	0.975–0.994	0.001
QRS duration	1.009	1.006–1.013	<0.001	1.010	1.005–1.014	<0.001
Left ventricle	1.037	1.024–1.050	<0.001	1.003	0.983–1.022	0.789
Right ventricle	1.063	1.039–1.087	<0.001	1.015	0.985–1.045	0.329
Left atrium	1.055	1.040–1.070	<0.001	1.047	1.025–1.069	<0.001
LVEF	0.964	0.950–0.979	<0.001	0.980	0.960–1.001	0.057
NT-pro-BNP	5.665	3.587–8.945	<0.001
FBG	1.098	1.043–1.156	<0.001	1.098	1.027–1.174	0.006
Creatinine	1.004	1.002–1.007	0.001	1.003	1.000–1.006	0.053

Notes: The variables analyzed in the multivariate Cox mode included age, sex, ventricular premature beat, drinking and smoke status, disease duration, NYHA functional classes, systolic blood pressure, QRS duration, left ventricular, right ventricle, left atrium diameter, LVEF, FBG, and creatinine. Bold data signifies P<0.05.

Abbreviations: DCM, dilated cardiomyopathy; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; NT-pro-BNP, N-terminal fragment pro-brain natriuretic peptide; FBG, fasting blood glucose; CI, confidence interval; HR, Hazard ratio.