Peripartum cardiomyopathy: Evolution of patients treated with bromocriptine at the institute of cardiology of Abidjan

Abstract

Bromocriptine is a new specific treatment for peripartum cardiomyopathy (PPCM). The addition of bromocriptine to the standard treatment of heart failure has recently begun in our context. To compare the outcome of patients with a CMPP treated with bromocriptine to that of patients not treated with bromocriptine. We conducted a cross-sectional observational study for descriptive and analytical purposes from January 1st, 2010 to December 31st, 2017. According to the periods of study, consecutively, all patients hospitalized in the department of medicine for CMPP were included. We selected 88 patients including 40 untreated bromocritptine and 48 treated with bromocriptine. The mean age of the patients was 30.3 ± 6.4 years. The majority of patients had a low socio-economic level (78%). Mean gestity was 3.1 ± 2 pregnancies. The mean parity was 2.9 ± 1.9 children. The most common mode of decompensation was global heart failure (80.7%) followed by left heart failure (15.9%). The prescription of bromocriptine started in 2014. The intra-hospital evolution was favorable. No deaths were recorded. The average length of hospital stay was 5.06 ± 2.12 days (range: 2 and 14 days). In post-hospitalization, we deplored 13.6% of deaths. LVEF < 35% was the poorly understood prognostic factor (63.6%) followed by late diagnosis (62.5%), LV dilatation ≥ 60 mm (56.8%). There was no significant difference in evolutionary parameters and poor prognostic factors between patients treated with bromocriptine and untreated patients. The probability of survival for patients treated with bromocriptine was higher. However, this difference was not statistically significant (Log Rank = 0.4117). Reducing the number of post-hospital deaths in patients treated with bromocriptine encourages the use of this treatment in our context.