| The Fontan patient: inconsistencies in medication therapy across seven pediatric heart network centers. | |
| | |
MedLine Citation:
|
PMID: 20938655 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Patients who have undergone the Fontan procedure are at risk for thrombosis, ventricular dysfunction, and valve regurgitation, but data to guide the medical treatment and prevention of these adverse outcomes in this population are lacking. This analysis examined medication usage among Fontan patients by putative indication and by study center. The medical history and current medications of 546 Fontan subjects, ages 6-18 years, were assessed in a Pediatric Heart Network multicenter cross-sectional study. Cardiac imaging was performed within 3 months of enrollment. The majority of the subjects (64%) were taking two or more medications. Antithrombotics were taken by 86% of those with a history of stroke, thrombosis, or both and 67% of those without such a history (P = 0.01). Conversely, 14% of those with a history of stroke, thrombosis, or both were taking no antithrombotic. Angiotensin-converting enzyme inhibitor (ACEi) therapy was independently associated with moderate or severe atrioventricular valve regurgitation (P = 0.004), right ventricular morphology (P < 0.001), and shorter time since Fontan (P = 0.004) but not with ventricular systolic dysfunction. Glycoside therapy and diuretic therapy each was associated with older age at Fontan (P = 0.001 and P = 0.023, respectively) and a history of post-Fontan arrhythmia (P < 0.001 and P = 0.003, respectively) but not with ventricular systolic dysfunction. Medication use rates varied widely among the centers, even with controls for center differences in patient characteristics. Prospective therapeutic trials are needed to guide the medical treatment of Fontan patients. |
| | |
Authors:
|
Page A W Anderson; Roger E Breitbart; Brian W McCrindle; Lynn A Sleeper; Andrew M Atz; Daphne T Hsu; Minmin Lu; Renee Margossian; Richard V Williams |
Related Documents
:
|
17563575 - Karl samuel ritter von basch: the sphygmomanometer and the empire. 12790815 - Startin's pneumatic inhaler. 2669005 - Expertise, procedure and the possibility of a comparative history of forensic psychiatr... 17641125 - Lymphedema of the lower extremity: is it genetic or nongenetic? 19876895 - American journal of medical genetics part a: volume 149a, number 11, november 2009. 8097195 - Dose response of prophylactic antipsychotics. |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural Date: 2010-10-12 |
Journal Detail:
|
Title: Pediatric cardiology Volume: 31 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2010 Nov |
Date Detail:
|
Created Date: 2010-11-12 Completed Date: 2011-03-24 Revised Date: 2011-07-26 |
Medline Journal Info:
|
Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1219-28 Citation Subset: IM |
Affiliation:
|
Department of Pediatrics, Duke University Medical Center, Durham, NC, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adrenergic beta-Antagonists / administration & dosage, adverse effects Angiotensin-Converting Enzyme Inhibitors / administration & dosage, adverse effects Anti-Arrhythmia Agents / administration & dosage, adverse effects Calcium Channel Blockers / administration & dosage, adverse effects Chi-Square Distribution Child Cross-Sectional Studies Diagnostic Imaging Diuretics / administration & dosage, adverse effects Female Fontan Procedure* Glycosides / administration & dosage, adverse effects Heart Defects, Congenital / drug therapy*, surgery* Humans Male Physician's Practice Patterns / statistics & numerical data* Postoperative Complications / epidemiology*, prevention & control* Regression Analysis Thrombolytic Therapy / adverse effects, methods United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
|
HL068269/HL/NHLBI NIH HHS; HL068270/HL/NHLBI NIH HHS; HL068279/HL/NHLBI NIH HHS; HL068281/HL/NHLBI NIH HHS; HL068285/HL/NHLBI NIH HHS; HL068288/HL/NHLBI NIH HHS; HL068290/HL/NHLBI NIH HHS; HL068292/HL/NHLBI NIH HHS; U01 HL068285-10/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Anti-Arrhythmia Agents; 0/Calcium Channel Blockers; 0/Diuretics; 0/Glycosides |
| Comments/Corrections | |
Comment In:
|
Pediatr Cardiol. 2011 Feb;32(2):248-9
[PMID:
21210092
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Temporary transumbilical stenting of the ductus venosus in neonates with obstructed infradiaphragmat...
Next Document: Fine-Scale Horizontal and Vertical Micro-distribution Patterns of Testate Amoebae Along a Narrow Fen...