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Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria

Karaye, Kamilu M. (author)
Umeå universitet,Avdelningen för medicin,Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria; Department of Medicine, Bayero University, Kano, Nigeria; Hatter Institute for Cardiovascular Research in Africa & CHI, Cape Town, South Africa
Ishaq, Naser A. (author)
Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
Sai'du, Hadiza (author)
Department of Medicine, Bayero University, Kano, Nigeria; Department of Medicine, Murtala Mohammed Specialist Hospital, Kano, Nigeria
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Balarabe, Sulaiman A. (author)
Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
Ahmed, Bashir G. (author)
Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
Adamu, Umar G. (author)
Department of Medicine, Federal Medical Centre, Bidda, Nigeria & Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Mohammed, Idris Y. (author)
Department of Chemical Pathology, Aminu Kano Teaching Hospital, Medicine Bayero University, Kano, Nigeria
Oboirien, Isa (author)
Department of Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
Umuerri, Ejiroghene M. (author)
Department of Medicine, Delta State University Teaching Hospital, Oghara, Nigeria
Mankwe, Abaram C. (author)
Department of Medicine, Federal medical centre, Yenagoa, Yenagoa, Nigeria
Shidali, Vincent Y. (author)
Department of Medicine, Federal Medical Center, Keffi, Nigeria
Dodiyi-Manuel, Sotonye (author)
Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Njoku, Paschal (author)
University of Nigeria Teaching Hospital, Enugu, Nigeria
Olunuga, Taiwo (author)
Department of Medicine, Federal Medical centre, Abeokuta, Nigeria
Josephs, Veronica (author)
Department of Medicine, University of Benin Teaching Hospital, Benin, Nigeria
Mbakwem, Amam C. (author)
Department of Medicine, University of Lagos, Lagos, Nigeria
Ogah, Okechukwu S. (author)
Department of Medicine, University College Hospital, Ibadan, Nigeria
Tukur, Jamilu (author)
Department of Obstetrics and Gynecology, Bayero University, Kano, Nigeria
Okeahialam, Basil (author)
Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
Stewart, Simon (author)
Torrens University Australia, SA, Adelaide, Australia
Henein, Michael (author)
Umeå universitet,Avdelningen för medicin
Sliwa, Karen (author)
Hatter Institute for Cardiovascular Research in Africa & CHI, Cape Town, South Africa
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 (creator_code:org_t)
2021-06-17
2021
English.
In: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 8:4, s. 3257-3267
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https://umu.diva-por... (primary) (Raw object)
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Aims: The prospective, multicentre Peripartum Cardiomyopathy in Nigeria (PEACE) registry originally demonstrated a high prevalence of peripartum cardiomyopathy (PPCM) among patients originating from Kano, North-West Nigeria. In a post hoc analysis, we sought to determine if this phenomenon was characterized by a differential case profile and outcome among PPCM cases originating elsewhere.Methods and results: Overall, 199 (81.6%) of a total 244 PPCM patients were recruited from three sites in Kano, compared with 45 patients (18.4%) from 11 widely dispersed centres across Nigeria. Presence and extent of ventricular myocardial remodelling during follow-up, relative to baseline status, were assessed by echocardiography. During median 17 months follow-up, Kano patients demonstrated significantly better myocardial reverse remodelling than patients from other sites. Overall, 50.6% of patients from Kano versus 28.6% from other regions were asymptomatic (P = 0.029) at study completion, with an accompanying difference in all-cause mortality (17.6% vs. 22.2% respectively, P = 0.523) not reaching statistical significance. Alternatively, 135/191 (84.9%) of Kano patients had selenium deficiency (<70 μg/L), and 46/135 (34.1%) of them received oral selenium supplementation. Critically, those that received selenium supplementation demonstrated better survival (6.5% vs. 21.2%; P = 0.025), but the supplement did not have significant impact on myocardial remodelling.Conclusions: This study has shown important non-racial regional disparities in the clinical features and outcomes of PPCM patients in Nigeria, that might partly be explained by selenium supplementation.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Outcomes
PEACE registry
Peripartum cardiomyopathy
Regional disparities
Selenium

Publication and Content Type

ref (subject category)
art (subject category)

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