(2/2) Randomized Evaluation of Bromocriptine In Myocardial Recovery THerapy for Peripartum Cardiomyopathy (REBIRTH)

摘要 美国是发达国家中孕产妇死亡率最高的国家之一， 是少数几个这一比率正在上升的国家之一。围产期心肌病（PPCM） 仍然是孕产妇发病和死亡的一个主要原因。虽然改善了心肌 超过一半的PPCM妇女在产后12个月内出现功能障碍， 那些没有康复的人会患上慢性心力衰竭，5-10%的妇女死亡或需要 在产后第一年进行心脏移植催乳素的抑制作用 多巴胺受体激动剂溴隐亭似乎改善了三项临床研究的结果 的PPCM。一个欧洲工作组最近提出的建议建议是， 溴隐亭与标准心力衰竭治疗;然而，没有随机试验比较 标准治疗加溴隐亭的标准治疗已在多种族 北美队列。本次调查的目的是评估是否增加了 溴隐亭与标准心力衰竭治疗相比可改善PPCM女性患者的预后， 随机对照试验。 匹兹堡大学临床试验与数据协调中心（CCDC）建议， 作为拟定随机评价的数据协调中心（DCC） 溴隐亭治疗围产期心肌病（REBIRTH）研究。我们目前服务于 作为众多单中心和多中心临床试验的DCC，我们支持许多 研究的复杂方面，包括项目管理、方案制定、数据 管理、监管支持、统计分析和数据发布。CCDC将 与研究者合作，设计、实施、协调和分析拟议的 REBIRTH临床试验具体而言，我们建议1）提供方案协调， 在重生的所有阶段（UG 3和UH 3）提供行政支持; 2）协调 在UG 3阶段制定方案，在整个 研究，并建立与关键核心设施的合作; 3）适应和维持现有的 基于网络的数据管理和跟踪系统， 重生;和4）为设计和统计分析提供全面的专业知识， 重生

ABSTRACT The United States has one of the highest rates of maternal mortality in the developed world, and is one of few countries where this rate is increasing. Peripartum cardiomyopathy (PPCM) remains a major cause of maternal morbidity and mortality. While improvement in myocardial function occurs within the first 12 months postpartum in more than half of women with PPCM, those who do not recover are left with chronic heart failure and 5-10% of women die or require cardiac transplantation during the first-year post-partum. Inhibition of prolactin with the dopamine agonist bromocriptine appears to improve outcomes in three previous clinical studies of PPCM. Recent recommendations from a European working group suggest the addition of bromocriptine to standard heart failure therapy; however, no randomized trial comparing standard therapy to standard therapy plus bromocriptine has been performed in a multi-racial North American cohort. The purpose of this investigation is to evaluate whether the addition of bromocriptine to standard heart failure therapy improves outcomes in women with PPCM in a randomized controlled trial. The University of Pittsburgh Center for Clinical Trials & Data Coordination (CCDC) proposes to serve as the Data Coordinating Center (DCC) for the proposed Randomized Evaluation of Bromocriptine Therapy for Peripartum Cardiomyopathy (REBIRTH) study. We currently serve as the DCC for numerous single- and multi-center clinical trials in which we support many complex aspects of the study including project management, protocol development, data management, regulatory support, statistical analyses, and data dissemination. The CCDC will collaborate with study investigators to design, conduct, coordinate, and analyze the proposed REBIRTH clinical trial. Specifically, we propose to 1) provide program coordination and administrative support throughout all phases (UG3 and UH3) of REBIRTH; 2) coordinate protocol development during the UG3 phase, provide regulatory management throughout the study, and establish collaborations with key core facilities; 3) adapt and maintain an existing web-based data management and tracking system to enhance the integrity and rigor of REBIRTH; and 4) provide comprehensive expertise for the design and statistical analysis of REBIRTH.