Effective High Dose Multi-Drug Treatment Regimen Favours Event Free Survival Rate in DCMP Patients.

ABSTRACT

Background: To study the effect of multidrug treatment regimen in the patient of DCMP (Dilated cardiomyopathy) compared to single drug/ low dose multi drug regimen. Methods: A total of 40 patients diagnosed with DCMP (both ischemic and non-ischemic) in the last 5 years attending to Cardiology OPD/ Inpatients in National Institute of Medical sciences, Jaipur were enrolled in the study. Out of 40 patients, 20 were kept on routine treatment regimens like diuretics, beta-blockers, angiotensinogen converting enzyme inhibitor/ Angiotensin receptor blockers (ACEI/ARB), either of them or all three of them in low dose. The other 20 patients were started on mineralocorticoid receptor antagonists (MRA’s), beta-blockers, ACEI all together with gradual increments of doses to a higher level. Both these groups were followed for 2 years and we found that patient groups with effective high dose multi drug regimen has good event free survival rate compared to traditional single drug /low dose multiple regimen. Tests of statistical significance were done using Chi-square Test. Results: Out of 20 patients in normal (routine treatment regimen) 12 patients presented with congestive cardiac failure (CCF) ,15 with dyselectrolemia ,10 with hypotensive episodes and 6 deaths were seen compared to 5 patients with CCF, 5 with dyselectrolemia, 8 with hypotension and 2 deaths were seen in high dose multi drug regimen. Out of this episodes of CCF (p=0.002), dyselectrolemia (p=0.001) are statistically significant. Conclusion: High dose MDR is preferable for event free survival rate in patients of DCMP.