Differences in Clinical Profile of African-American Women With Peripartum Cardiomyopathy in the United States

Abstract Background Peripartum cardiomyopathy (PPCM) is a rare and heterogeneous disease with a higher prevalence in African Americans (AAs) in the USA. The clinical features and prognosis of PPCM in AAs have not been sufficiently characterized. Methods We studied 52 AA patients with PPCM and compared clinical characteristics and outcome with those of 104 white patients. Results AA patients were significantly younger (26 ± 7 vs 30 ± 6 years; P P  = .03), and were diagnosed more commonly postpartum rather then antepartum (83% vs 64%; P  = .03). The rate of left ventricular (LV) recovery (LV ejection fraction [LVEF] ≥50%) was significantly lower in AAs (40% vs 61%; P  = .02). AA women also had a larger LV end-diastolic diameter (57 ± 10 vs 51 ± 6 mm; P  = .004) as well as lower LVEF (40% ± 16.7% vs 46% ± 14%; P  = .002) at the last follow-up. Moreover, AA patients had a significantly higher incidence of the combined end points of mortality and cardiac transplantation ( P  = .03) and showed a strong trend ( P  = .09) for increased mortality. Conclusions AA patients with PPCM in the USA have a different clinical profile and worse prognosis compared with white patients. Further research to evaluate potentially correctable causes for these differences is warranted.