Key result
In patients with Takotsubo syndrome treated predominantly with antithrombotic and heart failure therapies, left ventricular ejection fraction significantly improved from 49.1% to 64.1% (p<0.001) at 2 months, with a 12% MACE rate at 24 months.
Cohort (n=72)
No
In patients with Takotsubo syndrome, discharge treatment with antithrombotic and heart failure therapies was associated with rapid recovery of left ventricular function and a low rate of major adverse clinical events.
Answers are grounded in this paper and cite their sources.
Supports standard heart failure and antithrombotic regimens for rapid functional recovery in Takotsubo syndrome;.
BACKGROUND: To date there is no validated evidence for standardized treatment of patients with Takotsubo syndrome (TTS). Medication therapy after final TTS diagnosis remains unclear. Previous data on patient outcome is ambivalent. Aim of this study was to evaluate medication therapy in TTS and to analyze patient outcome. METHODS: Within an observational retrospective cohort study we analyzed our medical records and included 72 patients with TTS that underwent cardiovascular magnetic resonance imaging (CMR) after a median of 2 days interquartile range (IQR 1-3.5). We investigated medication therapy at discharge. Medication implementation and major adverse clinical events (MACE) were prospectively evaluated after a median follow-up of 24 months (IQR 6-43). Left ventricular function, myocardial oedema and late gadolinium enhancement were analyzed in a CMR follow-up if available. RESULTS: Antithrombotic therapy was recommended in 69 (96%) patients including different combinations. Antiplatelet monotherapy was prescribed in 28 (39%) patients. Dual antiplatelet therapy was recommended in 29 (40%) patients. Length of therapy duration varied from one to twelve months. Only in one case oral anticoagulation was prescribed due to apical ballooning with a left ventricular ejection fraction <30%. In all other cases oral anticoagulation was recommended due to other indications. ß-adrenoceptor antagonists and ACE inhibitors were recommended in 63 (88%), mineralocorticoid receptor antagonists were prescribed in 31 (43%) patients. After a median of 2 months (IQR 1.3-2.9) left ventricular function significantly recovered (49.1% ± 10.1 vs. 64.1% ± 5.7, P < 0.001) and myocardial oedema significantly decreased (13.5 ± 11.3 vs. 0.6% ± 2.4, P = <0.001) in the CMR follow-up. The 30-day mortality was 1%. MACE rate after 24 months was 12%. CONCLUSION: Although therapy guidelines for TTS currently do not exist, we found that the majority of patients were treated with antithrombotic and heart failure therapy for up to twelve months. Left ventricular function and myocardial oedema recovered rapidly within the first two months. Outcome analysis showed a low bleeding rate and a high short-term survival. Therefore, TTS patients might benefit from antithrombotic and heart failure therapy at least for the first two months.
No takes yet. Share an insight, caveat, or question.
Abanador-Kamper et al. (2017) conducted a cohort in Takotsubo syndrome (n=72). Antithrombotic and heart failure therapy vs. Baseline was evaluated on Left ventricular ejection fraction (LV-EF) at follow-up CMR (median 2.3 months) (p=<0.001). In patients with Takotsubo syndrome treated predominantly with antithrombotic and heart failure therapies, left ventricular ejection fraction significantly improved from 49.1% to 64.1% (p<0.001) at 2 months, with a 12% MACE rate at 24 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: