Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry.

• Tác giả: Johann Bauersachs, Michael Böhm, Hasan Ali Farhan, Sorel Goland, Denise Hilfiker-Kleiner, Julian Hoevelmann, Alice Jackson, Alexandre Mebazaa, Wouter Ouwerkerk, Mark C Petrie, Petar M Seferović, Karen Sliwa, Jasper Tromp, Peter van der Meer, Bart Johan van Essen, Charle Viljoen
• Ngôn ngữ: eng
• Ký hiệu phân loại: 297.1248 Sources of Islam
• Thông tin xuất bản: England : European heart journal , 2025
• Bộ sưu tập: NCBI
• ID: 699733

Tóm tắt

 BACKGROUND AND AIMS: 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. METHODS: Peripartum cardiomyopathy 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 the missing data. RESULTS: Among the 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 = .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 = .021]. This association remained after applying multiple imputation and methods to correct for confounding by indication (inverse probability weighted model on imputed data: OR 0.47, 95% CI 0.31-0.70, P <
  0.001). Thromboembolic events were observed in 6.0% of the patients in the bromocriptine group vs. 5.6% in the standard of care group (P = .900). CONCLUSIONS: Among women with PPCM, bromocriptine treatment in addition to standard of care was associated with better maternal outcomes after 6 months.