There has been conflicting evidence on whether the outcomes of ischemic (ICM) and non ischemic (NICM) exit. While older studies suggested the ICMP have worse outcomes, recent data suggest that the outcomes may be the same. The aim of this analysis is to explore the differences between ICM and NICMP in a well-treated contemporary cohort with heart failure with reduced ejection fraction (HFrEF).
A post hoc analysis of 2,805 (HFrEF) patients (Mean age 57.4, 70% females) were included. ICMP was defined HFrEF in the presence of obstructive coronary artery disease or myocardial infarction. Patients were followed up for a median duration of 4.4 years for all cause mortality.
A total of 1,675 patients had ICM while 1,130 patients had NICMP. Patients with ICMP were older, more often females, with higher prevalence of hypertension, diabetes, and dyslipidemia. NICMP patient had lower ejection fraction (33.6 ± 8.7 vs. 31.5 ± 11.1, p= <0.0001). Patients with NICMP were more often treated with beta blocker and aldactone, with no differences in ACEI/ARB. After a median follow-up duration of 4.4 years, 436 patients died (147(14.7%) in the NICMP and 289 (18.86%)in the ICMP). After adjusting for confounders, including differences in medical therapy, ICMP was associated with increased risk of all-cause mortality (Hazarad ratio 1.62, 95% CI 1.32-2.04)
In the current era, ischemic cardiomyopathy continues to be associated with worse outcomes. This may be partially attributed to differences in medical therapies’.