Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry
Peripartum cardiomyopathy (PPCM) remains a serious threat to maternal health around the world. While bromocriptine, in addition to standard treatment for heart failure, presents a promising pathophysiology-based disease-specific treatment option in PPCM, the evidence regarding its efficacy remains l...
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| creator | van der Meer, Peter van Essen, Bart Viljoen, Charle Böhm, Michael Jackson, Alice Hilfiker-Kleiner, Denise Hoevelmann, Julian Mebazaa, Alexandre Farhan, Hasan Ali Goland, Sorel Ouwerkerk, Wouter Petrie, Mark C Seferović, Petar M Tromp, Jasper Sliwa, Karen Bauersachs, Johann |
| description | Peripartum cardiomyopathy (PPCM) remains a serious threat to maternal health around the world. While bromocriptine, in addition to standard treatment for heart failure, presents a promising pathophysiology-based disease-specific treatment option in PPCM, the evidence regarding its efficacy remains limited. This study aimed to determine whether bromocriptine treatment is associated with improved maternal outcomes in PPCM.
PPCM patients from the EORP PPCM registry with available follow-up were included. The main exposure of this exploratory non-randomized analysis was bromocriptine treatment, and the main outcome was a composite endpoint of maternal outcome (death or hospital readmission within the first 6 months after diagnosis, or persistent severe left ventricular dysfunction [left ventricular ejection fraction |
| doi_str_mv | 10.1093/eurheartj/ehae559 |
| format | Article |
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PPCM patients from the EORP PPCM registry with available follow-up were included. The main exposure of this exploratory non-randomized analysis was bromocriptine treatment, and the main outcome was a composite endpoint of maternal outcome (death or hospital readmission within the first 6 months after diagnosis, or persistent severe left ventricular dysfunction [left ventricular ejection fraction <35%] at 6-month follow-up). Inverse probability weighting was used to minimize the effects of confounding by indication. Multiple imputation was used to account for missing data.
Among 552 patients with PPCM, 85 were treated with bromocriptine (15%). The primary endpoint was available in 491 patients (89%) and occurred in 18 out of 82 patients treated with bromocriptine in addition to standard of care (22%) and in 136 out of 409 patients treated with standard of care (33%) (p=0.044). In complete case analysis, bromocriptine treatment was associated with reduced adverse maternal outcome (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.10-0.83, p=0.021). This association remained after applying multiple imputation and methods to correct for confounding by indication (inverse probability weighted model on imputed data OR 0.39, 95% CI 0.19-0.81, p=0.011). Thrombo-embolic events were observed in 5.9% of the patients in the bromocriptine group versus 5.6% in the standard of care group (p=0.900).
Among women with PPCM, bromocriptine treatment in addition to standard of care was associated with better maternal outcomes after 6 months.</description><identifier>ISSN: 0195-668X</identifier><identifier>ISSN: 1522-9645</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehae559</identifier><identifier>PMID: 39221911</identifier><language>eng</language><publisher>England</publisher><ispartof>European heart journal, 2024-09</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c226t-b2115958a5d30dd75c89b288b337c0ad712ff6ab62518525ad0bdc7230a28d103</cites><orcidid>0000-0002-6061-4966 ; 0000-0001-6043-0713 ; 0000-0002-8272-0911 ; 0000-0002-9341-117X ; 0000-0002-5821-1113 ; 0000-0002-6333-9496 ; 0000-0002-2023-3026 ; 0000-0002-9705-4413</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39221911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Meer, Peter</creatorcontrib><creatorcontrib>van Essen, Bart</creatorcontrib><creatorcontrib>Viljoen, Charle</creatorcontrib><creatorcontrib>Böhm, Michael</creatorcontrib><creatorcontrib>Jackson, Alice</creatorcontrib><creatorcontrib>Hilfiker-Kleiner, Denise</creatorcontrib><creatorcontrib>Hoevelmann, Julian</creatorcontrib><creatorcontrib>Mebazaa, Alexandre</creatorcontrib><creatorcontrib>Farhan, Hasan Ali</creatorcontrib><creatorcontrib>Goland, Sorel</creatorcontrib><creatorcontrib>Ouwerkerk, Wouter</creatorcontrib><creatorcontrib>Petrie, Mark C</creatorcontrib><creatorcontrib>Seferović, Petar M</creatorcontrib><creatorcontrib>Tromp, Jasper</creatorcontrib><creatorcontrib>Sliwa, Karen</creatorcontrib><creatorcontrib>Bauersachs, Johann</creatorcontrib><title>Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Peripartum cardiomyopathy (PPCM) remains a serious threat to maternal health around the world. While bromocriptine, in addition to standard treatment for heart failure, presents a promising pathophysiology-based disease-specific treatment option in PPCM, the evidence regarding its efficacy remains limited. This study aimed to determine whether bromocriptine treatment is associated with improved maternal outcomes in PPCM.
PPCM patients from the EORP PPCM registry with available follow-up were included. The main exposure of this exploratory non-randomized analysis was bromocriptine treatment, and the main outcome was a composite endpoint of maternal outcome (death or hospital readmission within the first 6 months after diagnosis, or persistent severe left ventricular dysfunction [left ventricular ejection fraction <35%] at 6-month follow-up). Inverse probability weighting was used to minimize the effects of confounding by indication. Multiple imputation was used to account for missing data.
Among 552 patients with PPCM, 85 were treated with bromocriptine (15%). The primary endpoint was available in 491 patients (89%) and occurred in 18 out of 82 patients treated with bromocriptine in addition to standard of care (22%) and in 136 out of 409 patients treated with standard of care (33%) (p=0.044). In complete case analysis, bromocriptine treatment was associated with reduced adverse maternal outcome (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.10-0.83, p=0.021). This association remained after applying multiple imputation and methods to correct for confounding by indication (inverse probability weighted model on imputed data OR 0.39, 95% CI 0.19-0.81, p=0.011). Thrombo-embolic events were observed in 5.9% of the patients in the bromocriptine group versus 5.6% in the standard of care group (p=0.900).
Among women with PPCM, bromocriptine treatment in addition to standard of care was associated with better maternal outcomes after 6 months.</description><issn>0195-668X</issn><issn>1522-9645</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo9kDtPwzAYRS0EoqXwA1iQR5ZQP7Bjs0FVHlJRKwQSTJFjf6WpmjjYzpB_T1FLp7uce690ELqk5IYSzcfQhRWYkNZjWBkQQh-hIRWMZVreimM0JFSLTEr1OUBnMa4JIUpSeYoGXDNGNaVD9PUQfO1tqNpUNYBTAJNqaBI2jcO-S9bXEHHV4Ba2zParq7E1wVW-7n1r0qq_w2kFeDp_W-DFYvKKA3xXMYX-HJ0szSbCxT5H6ONx-j55zmbzp5fJ_SyzjMmUlYxSoYUywnHiXC6s0iVTquQ8t8S4nLLlUppSMkGVYMI4UjqbM04MU44SPkLXu902-J8OYirqKlrYbEwDvosFJ1orSaiUW5TuUBt8jAGWRRuq2oS-oKT4M1ocjBZ7o9vO1X6-K2twh8a_Qv4LZ2F2QA</recordid><startdate>20240902</startdate><enddate>20240902</enddate><creator>van der Meer, Peter</creator><creator>van Essen, Bart</creator><creator>Viljoen, Charle</creator><creator>Böhm, Michael</creator><creator>Jackson, Alice</creator><creator>Hilfiker-Kleiner, Denise</creator><creator>Hoevelmann, Julian</creator><creator>Mebazaa, Alexandre</creator><creator>Farhan, Hasan Ali</creator><creator>Goland, Sorel</creator><creator>Ouwerkerk, Wouter</creator><creator>Petrie, Mark C</creator><creator>Seferović, Petar M</creator><creator>Tromp, Jasper</creator><creator>Sliwa, Karen</creator><creator>Bauersachs, Johann</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6061-4966</orcidid><orcidid>https://orcid.org/0000-0001-6043-0713</orcidid><orcidid>https://orcid.org/0000-0002-8272-0911</orcidid><orcidid>https://orcid.org/0000-0002-9341-117X</orcidid><orcidid>https://orcid.org/0000-0002-5821-1113</orcidid><orcidid>https://orcid.org/0000-0002-6333-9496</orcidid><orcidid>https://orcid.org/0000-0002-2023-3026</orcidid><orcidid>https://orcid.org/0000-0002-9705-4413</orcidid></search><sort><creationdate>20240902</creationdate><title>Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry</title><author>van der Meer, Peter ; van Essen, Bart ; Viljoen, Charle ; Böhm, Michael ; Jackson, Alice ; Hilfiker-Kleiner, Denise ; Hoevelmann, Julian ; Mebazaa, Alexandre ; Farhan, Hasan Ali ; Goland, Sorel ; Ouwerkerk, Wouter ; Petrie, Mark C ; Seferović, Petar M ; Tromp, Jasper ; Sliwa, Karen ; Bauersachs, Johann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c226t-b2115958a5d30dd75c89b288b337c0ad712ff6ab62518525ad0bdc7230a28d103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van der Meer, Peter</creatorcontrib><creatorcontrib>van Essen, Bart</creatorcontrib><creatorcontrib>Viljoen, Charle</creatorcontrib><creatorcontrib>Böhm, Michael</creatorcontrib><creatorcontrib>Jackson, Alice</creatorcontrib><creatorcontrib>Hilfiker-Kleiner, Denise</creatorcontrib><creatorcontrib>Hoevelmann, Julian</creatorcontrib><creatorcontrib>Mebazaa, Alexandre</creatorcontrib><creatorcontrib>Farhan, Hasan Ali</creatorcontrib><creatorcontrib>Goland, Sorel</creatorcontrib><creatorcontrib>Ouwerkerk, Wouter</creatorcontrib><creatorcontrib>Petrie, Mark C</creatorcontrib><creatorcontrib>Seferović, Petar M</creatorcontrib><creatorcontrib>Tromp, Jasper</creatorcontrib><creatorcontrib>Sliwa, Karen</creatorcontrib><creatorcontrib>Bauersachs, Johann</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Meer, Peter</au><au>van Essen, Bart</au><au>Viljoen, Charle</au><au>Böhm, Michael</au><au>Jackson, Alice</au><au>Hilfiker-Kleiner, Denise</au><au>Hoevelmann, Julian</au><au>Mebazaa, Alexandre</au><au>Farhan, Hasan Ali</au><au>Goland, Sorel</au><au>Ouwerkerk, Wouter</au><au>Petrie, Mark C</au><au>Seferović, Petar M</au><au>Tromp, Jasper</au><au>Sliwa, Karen</au><au>Bauersachs, Johann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2024-09-02</date><risdate>2024</risdate><issn>0195-668X</issn><issn>1522-9645</issn><eissn>1522-9645</eissn><abstract>Peripartum cardiomyopathy (PPCM) remains a serious threat to maternal health around the world. While bromocriptine, in addition to standard treatment for heart failure, presents a promising pathophysiology-based disease-specific treatment option in PPCM, the evidence regarding its efficacy remains limited. This study aimed to determine whether bromocriptine treatment is associated with improved maternal outcomes in PPCM.
PPCM patients from the EORP PPCM registry with available follow-up were included. The main exposure of this exploratory non-randomized analysis was bromocriptine treatment, and the main outcome was a composite endpoint of maternal outcome (death or hospital readmission within the first 6 months after diagnosis, or persistent severe left ventricular dysfunction [left ventricular ejection fraction <35%] at 6-month follow-up). Inverse probability weighting was used to minimize the effects of confounding by indication. Multiple imputation was used to account for missing data.
Among 552 patients with PPCM, 85 were treated with bromocriptine (15%). The primary endpoint was available in 491 patients (89%) and occurred in 18 out of 82 patients treated with bromocriptine in addition to standard of care (22%) and in 136 out of 409 patients treated with standard of care (33%) (p=0.044). In complete case analysis, bromocriptine treatment was associated with reduced adverse maternal outcome (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.10-0.83, p=0.021). This association remained after applying multiple imputation and methods to correct for confounding by indication (inverse probability weighted model on imputed data OR 0.39, 95% CI 0.19-0.81, p=0.011). Thrombo-embolic events were observed in 5.9% of the patients in the bromocriptine group versus 5.6% in the standard of care group (p=0.900).
Among women with PPCM, bromocriptine treatment in addition to standard of care was associated with better maternal outcomes after 6 months.</abstract><cop>England</cop><pmid>39221911</pmid><doi>10.1093/eurheartj/ehae559</doi><orcidid>https://orcid.org/0000-0002-6061-4966</orcidid><orcidid>https://orcid.org/0000-0001-6043-0713</orcidid><orcidid>https://orcid.org/0000-0002-8272-0911</orcidid><orcidid>https://orcid.org/0000-0002-9341-117X</orcidid><orcidid>https://orcid.org/0000-0002-5821-1113</orcidid><orcidid>https://orcid.org/0000-0002-6333-9496</orcidid><orcidid>https://orcid.org/0000-0002-2023-3026</orcidid><orcidid>https://orcid.org/0000-0002-9705-4413</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current) |
| title | Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry |
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