Propensity Score Analysis of Possible Medication Effects on Outcomes in Patients With Systemic Right Ventricles

作者：Amrit Misra, Carla P. Rodríguez-Monserrate, Kimberlee Gauvreau, Mikael Dellborg, Flavia Fusco, Tripti Gupta, Joseph Kay, Shelby Kutty, Robert M. Kauling, Jeremy Nicolarsen, Jolien W. Roos‐Hesselink, Anitha S. John, Joshua Wong, Luke J. Burchill, Eric V. Krieger, Adam M. Lubert, Pastora Gallego, Marissa C. Kuo, Jamil Aboulhosn, Jonathan Cramer, Petra Antonová, David W. Baker, Payam Dehghani, Alexander R. Opotowsky, Alexandra van Dissel, Jasmine Grewal, Elizabeth Yeung, Susan M. Fernandes, Salil Ginde, Paul Khairy, Frank Han, Isabelle Vonder Muhll, William Wilson, W. Aaron Kay, Stephen Pylypchuk, Berardo Sarubbi, Clare O’Donnell, Fred H. Rodriguez, P. Jayadeva, David S. Celermajer, Sangeeta Shah, Timothy B. Cotts, Christopher DeZorzi, Anthony Magalski, Anne Marie Valente, Craig S. Broberg · 发表于：JACC Advances · 年份：2024 · DOI：10.1016/j.jacadv.2024.101443 · 被引用次数：12 · 研究领域：Congenital Heart Disease Studies、Mechanical Circulatory Support Devices、Pulmonary Hypertension Research and Treatments

Background: Patients with systemic right ventricle (SRV), either d-transposition of the great arteries following an atrial switch procedure or congenitally corrected transposition of the great arteries, develop severe right ventricular dysfunction, prompting appropriate medical therapy. However, the efficacy of beta-blockers and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors (ACEI) in SRV patients is unproven. Objectives: The objective of this study was to determine the effects of ACEI/ARB and beta-blockers on outcomes in SRV patients after accounting for likely cofounders affecting their use. Methods: From a retrospective, multicenter study on heart failure-related outcome in individuals with SRV, those who were taking an ACEI/ARB, beta-blocker, or both of these medication were identified. We performed a propensity analysis to match them to those not using these medications at their initial visit. Matching was based on a propensity score, which captured co-morbidities, demographics, and baseline echocardiographic parameters. Primary outcome of death, transplant, or mechanical circulatory support, and secondary outcomes of heart failure hospitalizations/atrial arrhythmias were analyzed respectively. Results: We identified 393 patients taking ACEI/ARB or beta-blocker, or taking both a beta-blocker and ACEI/ARB (62.1% male, median age 31.3 years) and 484 patients (56.4% male, median age of 26.0 years) who were neither on a beta-blocker nor on ACEI/ARB...