Cases of Peripartum Cardiomyopathy More Severe in African American Women

African American women were diagnosed with peripartum cardiomyopathy (PPCM) at a younger age, later in the postpartum period and were more likely to present with a left ventricular ejection fraction < 30 percent when compared with non–African American women, according to a cohort study published in the Journal of the American Medical Association.

Using 30 years of data from the University of Pennsylvania Health System, authors Olga Corazón Irizarry, MD, et al., also determined that African American women presented with more severe cases of PPCM, recovered less frequently and took at least twice as long to recover, despite apparent adequate treatment, when compared with their non–African American counterparts.

Per Irizarry, et al., these data suggest that African American women with PPCM have a different disease profile and trajectory compared with non–African American women. Moving forward, study authors write, “Further work is needed to understand to what extent these differences stem from genetic or socioeconomic differences and how treatment of African American patients might be tailored to improve health outcomes.”

In a corresponding commentary, Johann Bauersachs, MD, echoed this concern of socioeconomic disparity writing, “The findings of Irizarry, et al., point to either a more severe form of PPCM in African American patients or to socioeconomic factors that are associated with limited access to timely and advanced medical care.” He continues to say, “African American women in the peripartum period must be carefully evaluated, as well as all women with risk factors for PPCM, such as pregnancy-associated hypertension, twin pregnancy, and cesarean delivery.”

Bauersachs urges that, “given the poor prognosis for African American women with PPCM, maximum therapeutic efforts, including the use of bromocriptine, should be considered.”

Keywords: Female, Pregnancy, Peripartum Period, Bromocriptine, African Americans, Pregnancy, Twin, Postpartum Period, Cardiomyopathy, Dilated, Cesarean Section, Socioeconomic Factors, Hypertension

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