Heart Failure Therapy Improves Outcomes in Adults With Congenital Heart Disease and Left Ventricular Dysfunction
Authors' conclusion
GDMT uptitration was associated with improved cardiac function, less congestion, and a lower incidence of death/transplant. Overall GDMT score was low, and only 41% of patients had GDMT uptitration, suggesting suboptimal therapy and need for optimization of heart failure therapy in this population.
Study context
- Population
- Adults with congenital heart disease presenting with heart failure with reduced ejection fraction
- Participants
- 327 adults
- Comparison
- Patients with guideline-directed medical therapy (GDMT) uptitration vs patients without GDMT uptitration
- GDMT uptitrationn = 135
Main finding
As reported in the abstract
Relative ΔLVEF · 1-year follow-up
GDMT uptitration
32
± 12 · %
Without GDMT uptitration
15
± 7 · %
P < 0.001
Further findings
Death/transplant · 10-year incidence · lower with GDMT uptitration
P = 0.002
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Death/transplant, per higher ΔGDMT score and ΔLVEF — Higher ΔGDMT score · associated with a lower risk of death/transplant | 0.68 (0.54–0.83) | P < 0.001 | |
| Death/transplant, per higher ΔGDMT score and ΔLVEF — ΔLVEF · associated with a lower risk of death/transplant | 0.79 (0.65–0.96) | P = 0.002 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | GDMT uptitration | Without GDMT uptitration | Estimate | P value |
|---|---|---|---|---|
| Relative ΔNT-proBNP · 1-year follow-up · greater reduction with GDMT uptitration | −39 ± 15 % | −21 ± 19 % | P < 0.001 |
Baseline characteristics · baseline encounter
- Age
- 46 ± 16 years
- Left ventricular ejection fraction (LVEF)
- 31 ± 6%
- GDMT uptitration
- 135 (41%)
- Similar LVEF and NT-proBNP levels at baseline between groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Heart Failure Therapy Improves Outcomes in Adults With Congenital Heart Disease and Left Ventricular Dysfunction. JACC Adv. doi:10.
Summarised from the published abstract; every number is checked against it