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oai:repisalud.isciii.es:20.500.12105/164512024-11-29T04:37:17Zcom_20.500.12105_19604com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19605col_20.500.12105_16967

00925njm 22002777a 4500 dc Raposeiras-Roubín, Sergio author Núñez-Gil, Iván J author Jamhour, Karim author Abu-Assi, Emad author Conty, David Aritza author Vedia, Oscar author Almendro-Delia, Manuel author Sionis, Alessandro author Martin-Garcia, Agustin C author Corbí-Pascual, Miguel author Martínez-Sellés, Manuel author Uribarri, Aitor author Guillén, Marta author Acuña, José María García author País, Javier Lopez author Blanco, Emilia author Linares Vicente, José A author Flecha, Alejandro Sánchez Grande author Andrés, Mireia author Pérez-Castellanos, Alberto author Alonso, Joaquín author Rosselló, Xavier author Romo, Andrés Iñiguez author Feltes, Gisela author 2023-03 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. Rev Port Cardiol. 2023 Mar;42(3):237-246. 10.1016/j.repc.2022.02.010 2174-2030 Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology https://hdl.handle.net/20.500.13003/18891 36634757 http://hdl.handle.net/20.500.12105/16451 950235400001 Long-term prognostic impact of beta-blockers in patients with Takotsubo syndrome: Results from the RETAKO Registry