Cardiomyopathy and Obstructive Coronary Artery Disease: Causality or Chance?

Detection of coronary artery disease is essential in the evaluation of patients with dilated cardiomyopathy and is a common practice in our setting.However, it is important to emphasize that the presence of obstructive coronary artery disease, even if extensive, does not necessarily indicate the presence of ischemic cardiomyopathy, as both conditions may coexist without a causal relationship.( 1) Bawaskar et al. recently published a registry of 3023 patients with documented obstructive coronary artery disease defined as 70% stenosis in 1 of the left anterior descending coronary artery (LAD), circumflex artery, or right coronary artery and/or 50% stenosis of the left main coronary artery identified on invasive coronary angiography, who underwent cardiac magnetic resonance (CMR) imaging.In this study, 9.3% of patients had non-ischemic cardiomyopathy, and this subgroup had higher risk of cardiovascular events during follow-up.(2)