Evidence map›Paper›PMID 39759434›Full record

ArticleJACC. Advances2025

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

Amrit Misra, Carla P Rodriguez-Monserrate, Kimberlee Gauvreau, Mikael Dellborg, Flavia Fusco, Tripti Gupta, Joseph Kay, Shelby Kutty, Robert M Kauling, Jeremy Nicolarsen and 36 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

46 authors.

Amrit MisraBoston Children's Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Carla P Rodriguez-MonserrateBoston Children's Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Kimberlee GauvreauBoston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Mikael DellborgInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Flavia FuscoAdult Congenital Heart Disease Unit, Monaldi Hospital, Napoli, Italy.
Tripti GuptaDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Joseph KayColorado Adult and Teen Congenital Heart (C.A.T.C.H.) Program, Colorado University School of Medicine, Denver, Colorado, USA.
Shelby KuttyHelen B. Taussig Heart Center, Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA.
Robert M KaulingDepartment of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
Jeremy NicolarsenProvidence Adult and Teen Congenital Heart Program, Providence Spokane, Spokane, Washington, USA.
Jolien Roos-HesselinkDepartment of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
Anitha S JohnDivision of Pediatric Cardiology, Children's National Hospital, Washington, DC, USA.
Joshua WongDepartment of Medicine, Royal Melbourne Hospital, Melbourne, Australia.
Luke J BurchillDepartment of Medicine, Royal Melbourne Hospital, Melbourne, Australia.
Eric V KriegerUniversity of Washington Medical Center and Seattle Children's Hospital, Seattle, Washington, USA.
Adam M LubertCincinnati Children's Hospital Medical Center, Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Pastora GallegoEuropean Reference Network for Rare, Low Prevalence and Complex Disease of the Heart- ERN-Guard Heart, Amsterdam, the Netherlands.
Marissa KuoDivision of Cardiology, Department of Medicine, Emory University Hospital, Atlanta, Georgia, USA.
Jamil AboulhosnDivision of Cardiology, Department of Medicine, Ahmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, California, USA.
Jonathan CramerChildren's Hospital, Omaha & University of Nebraska Medical Center, Omaha, Nebraska, USA.
Petra AntonovaDepartment of Cardiovascular Surgery, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic.
David BakerDepartment of Cardiology, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
Payam DehghaniDepartment of Cardiology, Regina General Hospital, Regina, Saskatchewan, Canada.
Alexander R OpotowskyCincinnati Children's Hospital Medical Center, Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Alexandra van DisselDivision of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands.
Jasmine GrewalSt.Paul's Hospital, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Elizabeth YeungColorado Adult and Teen Congenital Heart (C.A.T.C.H.) Program, Colorado University School of Medicine, Denver, Colorado, USA.
Susan FernandesStanford University, School of Medicine, Departments of Pediatrics and Medicine, Palo Alto, California, USA.
Salil GindeDivision of Cardiology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.
Paul KhairyDepartment of Medicine, Montreal Heart Institute, Montreal Heart Institute, Montreal, Quebec, Canada.
Frank HanDepartment of Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Isabelle Vonder MuhllInternal Medicine/Cardiology, University of Alberta, Edmonton, Alberta, Canada.
William M WilsonDepartment of Medicine, Royal Melbourne Hospital, Melbourne, Australia.
William Aaron KayDivision of Cardiology, Krannert Institute of Cardiology, Indianapolis, Indiana, USA.
Stephen PylypchukInternal Medicine/Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Berardo SarubbiAdult Congenital Heart Disease Unit, Monaldi Hospital, Napoli, Italy.
Clare O'DonnellGreen Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand.
Fred RodriguezDivision of Cardiology, Department of Medicine, Emory University Hospital, Atlanta, Georgia, USA.
Pavithra S JayadevaPeter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Ontario, Canada.
David S CelermajerDepartment of Cardiology, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
Sangeeta ShahOchsner Medical Center, New Orleans, Los Angeles, USA.
Timothy CottsDivision of Cardiology, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
Christopher DeZorziDivision of Cardiology, Saint Luke's Mid America Heart Institute Hospital, Kansas City, Missouri, USA.
Anthony MagalskiDivision of Cardiology, Saint Luke's Mid America Heart Institute Hospital, Kansas City, Missouri, USA.
Anne Marie ValenteBoston Children's Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Craig S BrobergKnight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 at the time of initial clinic visit. Median follow-up was ∼8 years. After propensity matching, medication use was not associated with decreased mortality, heart failure hospitalizations, or arrhythmias. Hazard ratios remained positive for beta blockers, implying potential harm rather than benefit. Conclusions: In this large multicenter propensity-matched observational study, patients with SRV taking beta-blockers or ACEI/ARB did not have a benefit in survival or reduced hospitalization. The likelihood of demonstrating favorable effects in larger studies appears remote.

Indexed as

congenital heart diseascongestive heart failuresystemic right ventricletransposition of the great arteries

Identifiers

PMID39759434
PMCPMC11699599

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.