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

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 6 7v s 306 6 years; P ! .001), had a higher prevalence of gestational hypertension (61% vs 41%; P 5 .03), and were diagnosed more commonly postpartum rather then antepartum (83% vs 64%; P 5 .03). The rate of left ventricular (LV) recovery (LVejection fraction [LVEF] $50%) was significantly lower in AAs (40% vs 61%; P 5 .02). AA women also had a larger LV end-diastolic diameter (57 6 10 vs 51 6 6 mm; P 5 .004) as well as lower LVEF (40% 6 16.7% vs 46% 6 14%; P 5 .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 5 .03) and showed a strong trend (P 5 .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. (J Cardiac Fail 2013;19:214e218)