Most Read Articles
28 Dec 2017
Varenicline, while effective for smoking cessation, appears to significantly elevate the risk of cardiovascular hospitalization and emergency department visits, particularly for new users, a recent study shows.
26 Jan 2018
In children, a short duration of sleep appears to be a significant risk factor for elevated cardiometabolic risk, suggesting that parents need to be mindful of their children’s sleep hygiene, a recent Spanish study has shown.
21 Dec 2017
Physicians’ practice patterns in managing hypertension, and their awareness of blood pressure variability, were reported in a recent study in Singapore. We discussed some of the clinical practice gaps identified by this study with author, A/Prof. Teo Boon Wee.
21 Dec 2017
Results from the ASCOT-LLA study suggest that patient reports of muscle-related adverse events were more common when patients knew they were being treated with a statin. We discussed this phenomenon, known as the ‘nocebo effect’, with senior investigator, Prof. Peter Sever.

Advanced pulmonary vasodilators linked to greater survival in Eisenmenger syndrome

09 Sep 2017

Treatment with advanced pulmonary vasodilator therapy (AT) appears to confer survival benefits in patients with Eisenmenger syndrome (ES) whose illness severity may be greater prior to treatment, according to a study.

Researchers followed 253 adult ES patients (mean age 31 years; 60 percent female) from 12 adult congenital heart disease centres across Australia and New Zealand. Demographic, medical and outcome data were collected and analysed prospectively and retrospectively.

At diagnosis of ES, 64 percent had World Health Organization (WHO) functional class ≥3. Ventricular septal defect was the most common underlying lesion, identified in 33 percent of patients, including 21 percent with “complex” anatomy.

During a median follow-up of 9.1 years, majority of patients (72 percent) were prescribed at least one AT (49 percent single agent), with bosentan mostly (66 percent; n=168). The mean time on AT was 6 years.

Compared with nonexposed patients, those with AT exposure were more functionally impaired at presentation (WHO ≥3, 69 vs 51 percent; p=0.007) and more likely to have been prescribed anticoagulation (47 vs 27 percent; p=0.003). The risk of death/transplant per year was 4.8 percent in the AT-exposed group vs 8.4 percent in the never-exposed group.

Multivariable Cox proportional hazards analysis found AT exposure to be independently associated with greater survival (hazard ratio [HR] for survival, 2.27; 95 percent CI, 1.49 to 3.45; p<0.001), whereas WHO ≥3 at presentation was associated with a worse prognosis (HR for mortality, 1.82; 1.19 to 2.78; p=0.006).

“ES occurs in patients with a structurally abnormal heart where intracardiac or extracardiac systemic to pulmonary communications result in severe pulmonary vascular disease thence right to left shunting, leading to chronic cyanosis,” researchers said.

“The finding of greater long-term survival in those treated with AT as compared with those untreated may be instructive for both therapeutic algorithms in [patients] with ES and in the design of future randomized trials to confirm this association,” they added.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
28 Dec 2017
Varenicline, while effective for smoking cessation, appears to significantly elevate the risk of cardiovascular hospitalization and emergency department visits, particularly for new users, a recent study shows.
26 Jan 2018
In children, a short duration of sleep appears to be a significant risk factor for elevated cardiometabolic risk, suggesting that parents need to be mindful of their children’s sleep hygiene, a recent Spanish study has shown.
21 Dec 2017
Physicians’ practice patterns in managing hypertension, and their awareness of blood pressure variability, were reported in a recent study in Singapore. We discussed some of the clinical practice gaps identified by this study with author, A/Prof. Teo Boon Wee.
21 Dec 2017
Results from the ASCOT-LLA study suggest that patient reports of muscle-related adverse events were more common when patients knew they were being treated with a statin. We discussed this phenomenon, known as the ‘nocebo effect’, with senior investigator, Prof. Peter Sever.