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Peltenburg, Puck J.
[Author];
Kallas, Dania
[Author];
Bos, Johan M.
[Author];
Lieve, Krystien V.V
[Author];
Franciosi, Sonia
[Author];
Roston, Thomas M.
[Author];
Denjoy, Isabelle
[Author];
Sorensen, Katrina B.
[Author];
Ohno, Seiko
[Author];
Roses-Noguer, Ferran
[Author];
Aiba, Takeshi
[Author];
Maltret, Alice
[Author];
LaPage, Martin J.
[Author];
Atallah, Joseph
[Author];
Giudicessi, John R.
[Author];
Clur, Sally-Ann B.
[Author];
Blom, Nico A.
[Author];
Tanck, Michael
[Author];
Extramiana, Fabrice
[Author];
Kato, Koichi
[Author];
Barc, Julien
[Author];
Borggrefe, Martin
[Author];
Behr, Elijah R.
[Author];
Sarquella-Brugada, Georgia
[Author];
[...]
An international multicenter cohort atudy on β-blockers for the treatment of symptomatic children with catecholaminergic polymorphic ventricular tachycardia
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- Media type: E-Article
- Title: An international multicenter cohort atudy on β-blockers for the treatment of symptomatic children with catecholaminergic polymorphic ventricular tachycardia
- Contributor: Peltenburg, Puck J. [VerfasserIn]; Kallas, Dania [VerfasserIn]; Bos, Johan M. [VerfasserIn]; Lieve, Krystien V.V. [VerfasserIn]; Franciosi, Sonia [VerfasserIn]; Roston, Thomas M. [VerfasserIn]; Denjoy, Isabelle [VerfasserIn]; Sorensen, Katrina B. [VerfasserIn]; Ohno, Seiko [VerfasserIn]; Roses-Noguer, Ferran [VerfasserIn]; Aiba, Takeshi [VerfasserIn]; Maltret, Alice [VerfasserIn]; LaPage, Martin J. [VerfasserIn]; Atallah, Joseph [VerfasserIn]; Giudicessi, John R. [VerfasserIn]; Clur, Sally-Ann B. [VerfasserIn]; Blom, Nico A. [VerfasserIn]; Tanck, Michael [VerfasserIn]; Extramiana, Fabrice [VerfasserIn]; Kato, Koichi [VerfasserIn]; Barc, Julien [VerfasserIn]; Borggrefe, Martin [VerfasserIn]; Behr, Elijah R. [VerfasserIn]; Sarquella-Brugada, Georgia [VerfasserIn]; Tfelt-Hansen, Jacob [VerfasserIn]; Zorio, Esther [VerfasserIn]; Swan, Heikki [VerfasserIn]; Kammeraad, Janneke A.E. [VerfasserIn]; Krahn, Andrew D. [VerfasserIn]; Davis, Andrew [VerfasserIn]; Sacher, Frederic [VerfasserIn]; Schwartz, Peter J. [VerfasserIn]; Roberts, Jason D. [VerfasserIn]; Skinner, Jonathan R. [VerfasserIn]; van den Berg, Maarten P. [VerfasserIn]; Kannankeril, Prince J. [VerfasserIn]; Drago, Fabrizio [VerfasserIn]; Robyns, Tomas [VerfasserIn]; Haugaa, Kristina [VerfasserIn]; Tavacova, Terezia [VerfasserIn]; Semsarian, Christopher [VerfasserIn]; Till, Jan [VerfasserIn]; Probst, Vincent [VerfasserIn]; Brugada, Ramon [VerfasserIn]; Shimizu, Wataru [VerfasserIn]; Horie, Minoru [VerfasserIn]; Leenhardt, Antoine [VerfasserIn]; Ackerman, Michael J. [VerfasserIn]; Sanatani, Shubhayan [VerfasserIn]; van der Werf, Christian [VerfasserIn]; Wilde, Arthur A.M. [VerfasserIn]
-
imprint:
February 1, 2022
- Published in: Circulation ; 145(2022), 5 vom: Feb., Seite 333-344
- Language: English
- DOI: 10.1161/CIRCULATIONAHA.121.056018
- ISSN: 1524-4539
- Identifier:
- Keywords: atenolol ; child ; death, sudden, cardiac ; metoprolol ; nadolol ; polymorphic catecholergic ventricular tachycardia ; propranolol
- Origination:
-
Footnote:
Im Titel ist "beta" als griechischer Buchstabe dargestellt
Ursprünglich veröffentlicht: 7. Dezember 2021
- Description: Background: - - Symptomatic children with catecholaminergic polymorphic ventricular tachycardia (CPVT) are at risk for recurrent arrhythmic events. β-Blockers decrease this risk, but studies comparing individual β-blockers in sizeable cohorts are lacking. We aimed to assess the association between risk for arrhythmic events and type of β-blocker in a large cohort of symptomatic children with CPVT. - - Methods: - - From 2 international registries of patients with CPVT, RYR2 variant-carrying symptomatic children (defined as syncope or sudden cardiac arrest before β-blocker initiation and age at start of β-blocker therapy <18 years), treated with a β-blocker were included. Cox regression analyses with time-dependent covariates for β-blockers and potential confounders were used to assess the hazard ratio (HR). The primary outcome was the first occurrence of sudden cardiac death, sudden cardiac arrest, appropriate implantable cardioverter-defibrillator shock, or syncope. The secondary outcome was the first occurrence of any of the primary outcomes except syncope. - - Results: - - We included 329 patients (median age at diagnosis, 12 [interquartile range, 7-15] years, 35% females). Ninety-nine (30.1%) patients experienced the primary outcome and 74 (22.5%) experienced the secondary outcome during a median follow-up of 6.7 (interquartile range, 2.8-12.5) years. Two-hundred sixteen patients (66.0%) used a nonselective β-blocker (predominantly nadolol [n=140] or propranolol [n=70]) and 111 (33.7%) used a β1-selective β-blocker (predominantly atenolol [n=51], metoprolol [n=33], or bisoprolol [n=19]) as initial β-blocker. Baseline characteristics did not differ. The HRs for both the primary and secondary outcomes were higher for β1-selective compared with nonselective β-blockers (HR, 2.04 [95% CI, 1.31-3.17]; and HR, 1.99 [95% CI, 1.20-3.30], respectively). When assessed separately, the HR for the primary outcome was higher for atenolol (HR, 2.68 [95% CI, 1.44-4.99]), bisoprolol (HR, 3.24 [95% CI, 1.47-7.18]), and metoprolol (HR, 2.18 [95% CI, 1.08-4.40]) compared with nadolol, but did not differ from propranolol. The HR of the secondary outcome was only higher in atenolol compared with nadolol (HR, 2.68 [95% CI, 1.30-5.55]). - - Conclusions: - - β1-selective β-blockers were associated with a significantly higher risk for arrhythmic events in symptomatic children with CPVT compared with nonselective β-blockers, specifically nadolol. Nadolol, or propranolol if nadolol is unavailable, should be the preferred β-blocker for treating symptomatic children with CPVT.
- Access State: Open Access