ArticleEuropean heart journal. Cardiovascular pharmacotherapy2022
Medication in adults after atrial switch for transposition of the great arteries: clinical practice and recommendations.
Article in European heart journal. Cardiovascular pharmacotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Meta-analysis of RAAS inhibition in patients with a systemic right ventricle.International journal of cardiology. Congenital heart disease · 2026Article
- Clinical benefit of optimization of heart failure therapy after heart failure hospitalization in adults with CHD.International journal of cardiology. Congenital heart disease · 2026Article
- Evidence-based Management of Heart Failure in the Systemic Right Ventricle.Current cardiology reports · 2025Review
- Safety and Efficacy of Dapagliflozin in Patients With Systemic Right Ventricular Dysfunction: DAPA-SRV Trial.Journal of the American Heart Association · 2025Observational
- Discovery of Nelutroctiv (CK-136), a Selective Cardiac Troponin Activator for the Treatment of Cardiovascular Diseases Associated with Reduced Cardiac Contractility.Journal of medicinal chemistry · 2024Article
- Effect of Sodium-Glucose Cotransporter 2 Inhibitors in Adults With Congenital Heart Disease.Journal of the American College of Cardiology · 2024Article
- Sacubitril/valsartan in the treatment of systemic right ventricular failure.Heart (British Cardiac Society) · 2021Article
- Potential of eHealth smart technology in optimization and monitoring of heart failure treatment in adults with systemic right ventricular failure.European heart journal. Digital health · 2021Article
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Authors and funding
15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aimsHeart failure is the main threat to long-term health in adults with transposition of the great arteries (TGA) corrected by an atrial switch operation (AtrSO). Current guidelines refrain from recommending heart failure medication in TGA-AtrSO, as there is insufficient data to support the hypothesis that it is beneficial. Medication is therefore prescribed based on personal judgements. We aimed to evaluate medication use in TGA-AtrSO patients and examine the association of use of renin-angiotensin-aldosterone system (RAAS) inhibitors and β-blockers with long-term survival. METHODS AND
resultsWe identified 150 TGA-AtrSO patients [median age 30 years (interquartile range 25-35), 63% male] included in the CONCOR registry from five tertiary medical centres with subsequent linkage to the Dutch Dispensed Drug Register for the years 2006-2014. Use of RAAS inhibitors, β-blockers, and diuretics increased with age, from, respectively, 21% [95% confidence interval (CI) 14-40], 12% (95% CI 7-21), and 3% (95% CI 2-7) at age 25, to 49% (95% CI 38-60), 51% (95% CI 38-63), and 41% (95% CI 29-54) at age 45. Time-varying Cox marginal structural models that adjusted for confounding medication showed a lower mortality risk with use of RAAS inhibitors and β-blockers in symptomatic patients [hazard ratio (HR) = 0.13 (95% CI 0.03-0.73); P = 0.020 and HR = 0.12 (95% CI 0.02-0.17); P = 0.019, respectively]. However, in the overall cohort, no benefit of RAAS inhibitors and β-blockers was seen [HR = 0.93 (95% CI 0.24-3.63); P = 0.92 and HR = 0.98 (0.23-4.17); P = 0.98, respectively].
conclusionThe use of heart failure medication is high in TGA-AtrSO patients, although evidence of its benefit is limited. This study showed lower risk of mortality with use of RAAS inhibitors and β-blockers in symptomatic patients only. These findings can direct future guidelines, supporting use of RAAS inhibitors and β-blockers in symptomatic, but not asymptomatic patients.
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