The medical treatment of endomyocardial fibrosis in 2009

ObjectivesTo study the natural history of medically treated patients with endomyocardial fibrosis (EMF) and to see whether the usage of common drugs affected survival.DesignA real-world all-comers analysis with follow-up.SettingA teaching hospital.AnalysisCox proportional hazards multiple regression and Kaplan–Meier curves for survival with both univariate and multivariate analysis.ResultsThe mean age of this population was 40.5±5 years at first symptom. The mortality was also less than previous reports at 10.38%. The dominant type of EMF was dominant left ventricular EMF in 49, right ventricular EMF in 52 and biventricular EMF in 53. On univariate analysis by Kaplan–Meier curves and log-rank test patients on warfarin had a better survival (at 5, 10 and 15 years—97.3, 87.54% and 87.54%, respectively) compared with no warfarin at 5, 10 and 15 years (91.37%, 88.9% and 66.68%), log rank test NS. On multivariate analysis when sex, the presence of complications, use of ACE inhibitors, use of aldactone, use of digoxin, frusemide and warfarin and age (age at entering the study) were entered into the analysis, the following results were obtained—men had a shorter time to death. Furthermore, when patients taking aldactone and those not taking aldactone were examined it was found that those on aldactone had a higher mortality and shorter time to death.ConclusionOn analysis of the usage of warfarin, those not on it had a shorter time to death; likewise did older patients.