PMID- 34725781
OWN - NLM
STAT- MEDLINE
DCOM- 20220429
LR  - 20220429
IS  - 1573-7322 (Electronic)
IS  - 1382-4147 (Linking)
VI  - 27
IP  - 2
DP  - 2022 Mar
TI  - Effects of bromocriptine in peripartum cardiomyopathy: a systematic review and 
      meta-analysis.
PG  - 533-543
LID - 10.1007/s10741-021-10185-8 [doi]
AB  - Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening form 
      of heart failure (HF). Bromocriptine, a dopamine D2 agonist, has been used as an 
      adjunctive treatment for PPCM with controversial benefits. A comprehensive 
      literature search was conducted through June 2021. We included studies comparing 
      the outcomes of PPCM with or without bromocriptine use. Pooled risk ratio (RR) 
      with 95% confidence intervals (CI) and I(2) statistics were calculated. Composite 
      major adverse outcomes were defined by a composite of death, need for advanced HF 
      therapies, persistent New York Heart Association (NYHA) functional class III/V, 
      or left ventricular ejection fraction (LVEF) </= 35% at 6-month follow-up. LVEF 
      recovery was defined by improvement of LVEF to more than 50%. Eight studies (two 
      randomized-controlled, six observational) involving 593 PPCM patients were 
      included. Bromocriptine use was associated with significantly higher survival 
      (91.6% vs. 83.9%, RR 1.11 p = 0.02). Baseline LVEF was not significantly 
      different between the groups. LVEF at follow-up was significantly higher in the 
      bromocriptine group (53.3% vs. 41.8%, p < 0.001). There was no significant 
      association between bromocriptine use and lower composite major adverse outcomes 
      (13.7% vs. 33.3%, RR 0.60 p = 0.54) or LVEF recovery (46.9% vs. 46.8%, RR 0.94 
      p = 0.74). In conclusion, the addition of bromocriptine to standard HF treatment 
      in PPCM was associated with significantly higher survival and higher LVEF 
      improvement. No association with lower composite adverse clinical outcomes or 
      LVEF recovery was seen. The findings, although encouraging, warrant larger 
      randomized-controlled studies.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Trongtorsak, Angkawipa
AU  - Trongtorsak A
AUID- ORCID: 0000-0003-1855-029X
AD  - Department of Medicine, AMITA Health Saint Francis Hospital, IL, Evanston, USA. 
      angkawipa.t@gmail.com.
FAU - Kittipibul, Veraprapas
AU  - Kittipibul V
AD  - Division of Cardiology, Duke University Medical Center, Durham, NC, USA.
FAU - Mahabir, Sunita
AU  - Mahabir S
AD  - Cardiovascular Institute, Allegheny Health Network, Pittsburgh, PA, USA.
FAU - Ibrahim, Michel
AU  - Ibrahim M
AD  - Section of Cardiology, Temple University, Philadelphia, PA, USA.
FAU - Saint Croix, Garly R
AU  - Saint Croix GR
AD  - Division of Cardiology, Columbia University at Mount Sinai Medical Center, Miami 
      Beach, FL, USA.
FAU - Hernandez, Gabriel A
AU  - Hernandez GA
AD  - Division of Cardiovascular Diseases, Department of Medicine, University of 
      Mississippi Medical Center, Jackson, MS, USA.
FAU - Chaparro, Sandra
AU  - Chaparro S
AD  - Advanced Heart Failure Program, Baptist Health South Florida, Miami, FL, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20211101
PL  - United States
TA  - Heart Fail Rev
JT  - Heart failure reviews
JID - 9612481
RN  - 3A64E3G5ZO (Bromocriptine)
SB  - IM
MH  - Bromocriptine/pharmacology/therapeutic use
MH  - *Cardiomyopathies/drug therapy
MH  - Female
MH  - *Heart Failure/drug therapy
MH  - Humans
MH  - Peripartum Period
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular/drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Bromocriptine
OT  - Dopamine agonist
OT  - Heart failure
OT  - Peripartum cardiomyopathy
EDAT- 2021/11/03 06:00
MHDA- 2022/04/30 06:00
CRDT- 2021/11/02 06:25
PHST- 2021/10/23 00:00 [accepted]
PHST- 2021/11/03 06:00 [pubmed]
PHST- 2022/04/30 06:00 [medline]
PHST- 2021/11/02 06:25 [entrez]
AID - 10.1007/s10741-021-10185-8 [pii]
AID - 10.1007/s10741-021-10185-8 [doi]
PST - ppublish
SO  - Heart Fail Rev. 2022 Mar;27(2):533-543. doi: 10.1007/s10741-021-10185-8. Epub 
      2021 Nov 1.