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Titel: A global perspective on the management and outcomes of peripartum cardiomyopathy : a systematic review and meta-analysis
VerfasserIn: Hoevelmann, Julian
Engel, Mark E.
Muller, Elani
Hohlfeld, Ameer
Böhm, Michael
Sliwa, Karen
Viljoen, Charle
Sprache: Englisch
Titel: European Journal of Heart Failure
Bandnummer: 24
Heft: 9
Seiten: 1719-1736
Verlag/Plattform: Wiley
Erscheinungsjahr: 2022
Freie Schlagwörter: Peripartum cardiomyopathy
Systematic review
Meta-analysis
Complications
Outcomes
Mortality
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Aims Peripartum cardiomyopathy (PPCM) remains a major contributor to maternal morbidity and mortality worldwide. The disease is associated with various complications occurring mainly early during its course. Reported adverse outcomes include decompensated heart failure, thromboembolic complications, arrhythmias and death. We sought to systematically and comprehensively review published literature on the management and outcome of women with PPCM across different geographical regions and to identify possible predictors of adverse outcomes. Methods and results We performed a comprehensive search of relevant literature (2000 to June 2021) across a number of electronic databases. Cohort, case-control and cross-sectional studies, as well as control arms of randomized controlled trials reporting on 6- and/or 12-month outcomes of PPCM were considered eligible (PROSPERO registration: CRD42021255654). Forty-seven studies (4875 patients across 60 countries) met the inclusion criteria. Haemodynamic and echocardiographic parameters were similar across all continents. All-cause mortality was 8.0% (95% confidence interval [CI] 5.5–10.8, I2 = 79.1%) at 6 months and 9.8% (95% CI 6.2–14.0, I2 = 80.5%) at 12 months. All-cause mortality was highest in Africa and Asia/Pacific. Overall, 44.1% (95% CI 36.1–52.2, I2 = 91.7%) of patients recovered their left ventricular (LV) function within 6 months and 58.7% (95% CI 48.1–68.9, I2 = 75.8%) within 12 months. Europe and North America reported the highest prevalence of LV recovery. Frequent prescription of beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and bromocriptine/cabergoline were associated with significantly lower all-cause mortality and better LV recovery. Conclusion We identified significant global differences in 6- and 12-month outcomes in women with PPCM. Frequent prescription of guideline-directed heart failure therapy was associated with better LV recovery and lower all-cause mortality. Timely initiation and up-titration of heart failure therapy should therefore be strongly encouraged to improve outcome in PPCM.
DOI der Erstveröffentlichung: 10.1002/ejhf.2603
URL der Erstveröffentlichung: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2603
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-376439
hdl:20.500.11880/34058
http://dx.doi.org/10.22028/D291-37643
ISSN: 1879-0844
1388-9842
Datum des Eintrags: 18-Okt-2022
Bezeichnung des in Beziehung stehenden Objekts: Supporting Information
In Beziehung stehendes Objekt: https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fejhf.2603&file=ejhf2603-sup-0001-AppendixS1.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Prof. Dr. Michael Böhm
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes



Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons Creative Commons