Pentoxifylline may be Potentially Harmful in the Treatment of Peripartum Cardiomyopathy 

Olaf Forster*
Received Date: February 08, 2022 Accepted Date: March 08, 2022 Published Date: March 10, 2022

doi: 10.17303/jcvm.2022.8.102

Citation: Olaf Forster (2022) Pentoxifylline may be Potentially Harmful in the Treatment of Peripartum Cardiomyopathy. J Cardio Vasc Med 1: 1-10.

ABSTRACT FULL TEXT REFERENCES TABLES & FIGURES

 Abstract

 Introduction:

Peripartum cardiomyopathy (PPCM) is associated with a significant rate of mortality and hence there is intense interest in identifying the etiology of this disease and determine therapeutic strategies. Heart failure in patients with PPCM has been associated with inflammation and significant rise in the plasma levels of pro-inflammatory cytokines. Pentoxifylline (PTX), a methylxanthine derivative, has been shown to possess anti-inflammatory, anti-apoptotic and rheological properties and therefore reasoned to be a good candidate as an add-on option in the therapy of PPCM. 

Methods

We enrolled 80 PPCM patients. All received standard heart failure therapy. 41 patients were randomized to receive additional PTX and 39 received placebo. Clinical assessment, echocardiography and blood analysis were performed at baseline and after 6 months of therapy.

Results:

Patients in the PTX group started off with a slightly worse New York Heart Association functional class (NYHA FC). All other parameters were similar at baseline and after 6 months of treatment. Overall mortality rate was low (6.25%), but among the 5 patients who died during the follow up period, 4 had been in the PTX group and only 1 in the placebo group.

Conclusions:

Unexpectedly, we were not able to demonstrate improved mortality for PPCM patients through the addition of PTX 800mg TID to standard heart failure therapy. Rather it appears to be potentially harmful. In the absence of any demonstrable benefit for PPCM patients in this study and in the absence of other randomized trials on the subject, these results prompt us to underscore a note of caution against the use of PTX in addition to standard heart failure therapy in all PPCM patients, but especially in HIV-infected individuals with PPCM.

Keywords:

Peripartum Cardiomyopathy; Pentoxifylline; Clinical Trials; Pregnancy; PPCM; PTX; Treatment

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