Long-term prognostic impact of beta-blockers in patients with Takotsubo syndrome: Results from the RETAKO Registry
Raposeiras-Roubín, Sergio ; Núñez-Gil, Iván J. ; Jamhour, Karim ; Abu-Assi, Emad ; Conty, David Aritza ; Vedia, Oscar ; Almendro-Delia, Manuel ; Sionis, Alessandro ; Martin-Garcia, Agustin C. ; Corbí-Pascual, Miguel ; Martínez-Sellés, Manuel ; Uribarri, Aitor ; Guillén, Marta ; Acuña, José María García ; País, Javier Lopez ; Blanco, Emilia ; Linares Vicente, José A. ; Flecha, Alejandro Sánchez Grande ; Andrés, Mireia ; Pérez-Castellanos, Alberto ; Alonso, Joaquín ; Rosselló, Xavier ; Romo, Andrés Iñiguez ; Feltes, Gisela
Resumen: Background
No evidence-based therapy has yet been established for Takotsubo syndrome (TTS). Given the putative harmful effects of catecholamines in patients with TTS, beta-blockers may potentially decrease the intensity of the detrimental cardiac effects in those patients.
Objective
The purpose of this study was to assess the impact of beta-blocker therapy on long-term mortality and TTS recurrence.
Methods
The cohort study used the national Spanish Registry on TakoTsubo Syndrome (RETAKO). A total of 970 TTS post-discharge survivors, without pheochromocytoma, left ventricular outflow tract obstruction, sustained ventricular arrhythmias, and significant bradyarrhythmias, between January 1, 2003, and July 31, 2018, were assessed. Cox regression analysis and inverse probability weighting (IPW) propensity score analysis were used to evaluate the association between beta-blocker therapy and survival free of TTS recurrence.
Results
From 970 TTS patients, 582 (60.0%) received beta-blockers. During a mean follow-up of 2.5 ± 3.3 years, there were 87 deaths (3.6 per 100 patients/year) and 29 TTS recurrences (1.2 per 100 patient/year). There was no significant difference in follow-up mortality or TTS recurrence in unadjusted and adjusted Cox analysis (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.59–1.27, and 0.95, 95% CI 0.57–1.13, respectively). After weighting and adjusting by IPW, differences in one-year survival free of TTS recurrence between patients treated and untreated with beta-blockers were not found (average treatment effect −0.01, 95% CI −0.07 to 0.04; p=0.621).
Conclusions
In this observational nationwide study from Spain, there was no significant association between beta-blocker therapy and follow-up survival free of TTS recurrence.
Idioma: Inglés
DOI: 10.1016/j.repc.2022.02.010
Año: 2023
Publicado en: Revista portuguesa de cardiologia 42, 3 (2023), 237-246
ISSN: 0870-2551
Factor impacto JCR: 1.6 (2023)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 139 / 222 = 0.626 (2023) - Q3 - T2
Factor impacto CITESCORE: 2.7 - Cardiology and Cardiovascular Medicine (Q3)
Factor impacto SCIMAGO: 0.333 - Cardiology and Cardiovascular Medicine (Q3)
Tipo y forma: Artículo (Versión definitiva)
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Exportado de SIDERAL (2025-01-23-14:48:07)
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No evidence-based therapy has yet been established for Takotsubo syndrome (TTS). Given the putative harmful effects of catecholamines in patients with TTS, beta-blockers may potentially decrease the intensity of the detrimental cardiac effects in those patients.
Objective
The purpose of this study was to assess the impact of beta-blocker therapy on long-term mortality and TTS recurrence.
Methods
The cohort study used the national Spanish Registry on TakoTsubo Syndrome (RETAKO). A total of 970 TTS post-discharge survivors, without pheochromocytoma, left ventricular outflow tract obstruction, sustained ventricular arrhythmias, and significant bradyarrhythmias, between January 1, 2003, and July 31, 2018, were assessed. Cox regression analysis and inverse probability weighting (IPW) propensity score analysis were used to evaluate the association between beta-blocker therapy and survival free of TTS recurrence.
Results
From 970 TTS patients, 582 (60.0%) received beta-blockers. During a mean follow-up of 2.5 ± 3.3 years, there were 87 deaths (3.6 per 100 patients/year) and 29 TTS recurrences (1.2 per 100 patient/year). There was no significant difference in follow-up mortality or TTS recurrence in unadjusted and adjusted Cox analysis (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.59–1.27, and 0.95, 95% CI 0.57–1.13, respectively). After weighting and adjusting by IPW, differences in one-year survival free of TTS recurrence between patients treated and untreated with beta-blockers were not found (average treatment effect −0.01, 95% CI −0.07 to 0.04; p=0.621).
Conclusions
In this observational nationwide study from Spain, there was no significant association between beta-blocker therapy and follow-up survival free of TTS recurrence.
Idioma: Inglés
DOI: 10.1016/j.repc.2022.02.010
Año: 2023
Publicado en: Revista portuguesa de cardiologia 42, 3 (2023), 237-246
ISSN: 0870-2551
Factor impacto JCR: 1.6 (2023)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 139 / 222 = 0.626 (2023) - Q3 - T2
Factor impacto CITESCORE: 2.7 - Cardiology and Cardiovascular Medicine (Q3)
Factor impacto SCIMAGO: 0.333 - Cardiology and Cardiovascular Medicine (Q3)
Tipo y forma: Artículo (Versión definitiva)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. No puede utilizar el material para una finalidad comercial. Si remezcla, transforma o crea a partir del material, no puede difundir el material modificado.Exportado de SIDERAL (2025-01-23-14:48:07)
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Registro creado el 2025-01-23, última modificación el 2025-01-23