One-Year Cardiovascular Outcomes in Patients With Peripartum Cardiomyopathy

Abstract

Peripartum cardiomyopathy (PPCM) is an important cause of obstetrical morbidity. Few large national studies have investigated the cardiovascular outcomes of women with PPCM, particularly beyond the immediate postpartum period. We examined the cardiovascular outcomes of 1-year survivors of PPCM in a large commercially insured population. A retrospective cohort study was conducted with the use of administrative claims from patients aged 15-54 years insured by a national commercial payer during 2005-2012. Women with PPCM were identified and matched by means of propensity score modeling to a control cohort of women undergoing childbirth without cardiovascular complications by demographics, comorbidities, and delivery year. Incidence of cardiovascular complications was measured from 11 to 365 days after delivery. A total of 975 women with PPCM were included in the study. At 1 year after delivery, the most common major adverse cardiovascular events (MACEs) among the PPCM group were venous thromboembolism (2.2% vs 0.4%; P = .001), subsequent heart failure hospitalization (1.6% vs 0.1%; P < .001), and atrial fibrillation (1.0% vs 0%; P = .008). The PPCM cohort had a greater incidence of MACEs compared with matched control subjects (6.3% vs 0.6%; P < .001). In PPCM survivors at 1 year, substantial morbidity continues to occur beyond the peripartum period, with venous thromboembolism and subsequent heart failure hospitalization being the most common complications.