Discharge beta-blocker therapy was associated with a significant reduction in all-cause mortality in patients with Takotsubo cardiomyopathy (HR 0.58; 95% CI 0.47-0.72).
Meta-Analysis (n=9,586)
Do pharmacological therapies such as beta-blockers, ACEi/ARBs, or antiplatelets reduce all-cause mortality in patients with Takotsubo cardiomyopathy?
Prescribing beta-blockers at discharge is associated with significantly improved survival in patients with Takotsubo cardiomyopathy.
Hazard Ratio: 0.58 (95% CI 0.47–0.72)
Abstract Background Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, mimics acute coronary syndrome but is distinguished by reversible left ventricular dysfunction. Despite its transient nature, complications and outcomes can be life-threatening. To date, no clear evidence regarding treatment strategies has been fully established. Objectives We conducted a systematic review and meta-analysis to establish evidence on the efficacy of current treatment strategies for TTS and evaluate their impact on patient outcomes. Following PRISMA guidelines, we systematically searched PubMed, EMBASE, and Cochrane Library databases. Risk of bias was assessed using the ROBINS-I tool. Results 18 studies involving 9,586 patients were included in the quantitative synthesis. Beta-blockers were commonly prescribed both during admission and at discharge, with pooled analyses showing a significant reduction in all-cause mortality associated with discharge β-blocker therapy HR: 0.58 95% CI: 0.47-0.72. Single β-blocker use at admission effect on mortality with HR 1.22 95% CI: 0.86 - 1.72. ACEi/ARBs were beneficial with HR 0.92 95% CI: 0.67 - 1.25, as well as antiplatelet therapy at discharge with HR 0.70 95% CI: 0.37 - 1.31. Conclusions Our study revealed significant evidence of discharge β-blockers in improving all-cause mortality in Takotsubo cardiomyopathy patients. Guidelines regarding the management of TTS should establish clear evidence-based strategies to reduce mortality in this population.Graphical Abstract Results
Huu et al. (Sat,) conducted a meta-analysis in Takotsubo cardiomyopathy (n=9,586). Discharge beta-blocker therapy was evaluated on All-cause mortality (HR 0.58, 95% CI 0.47-0.72). Discharge beta-blocker therapy was associated with a significant reduction in all-cause mortality in patients with Takotsubo cardiomyopathy (HR 0.58; 95% CI 0.47-0.72).