Sistema de Salut de Catalunya
Impacto prognóstico a longo prazo do uso de beta-bloqueantes em doentes com síndrome de Takotsubo: resultados do Registo RETAKO
Institut Català de la Salut
[Raposeiras-Roubín S, Jamhour K, Abu-Assi E] Cardiology Department, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain. [Núñez-Gil IJ, Vedia O] Cardiology Department, Hospital Clínico San Carlos, Madrid, Spain. [Conty DA] Cardiology Department, Hospital de Navarra, Pamplona, Spain. [Andrés M] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-09-01T07:31:18Z
2023-09-01T07:31:18Z
2023-03
Beta-blocker; Mortality; Takotsubo
Bloqueador beta; Mortalidad; Takotsubo
Bloquejador beta; Mortalitat; Takotsubo
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.
The Retako webpage was funded by a non-conditional Astrazeneca scholarship.
Article
Published version
English
Miocardi - Malalties - Prognosi; Miocardi - Malalties - Tractament; Beta-blocadors - Ús terapèutic; DISEASES::Cardiovascular Diseases::Heart Diseases::Ventricular Dysfunction::Ventricular Dysfunction, Left::Takotsubo Cardiomyopathy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis; CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Neurotransmitter Agents::Adrenergic Agents::Adrenergic Antagonists::Adrenergic beta-Antagonists; Other subheadings::Other subheadings::/therapeutic use; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::disfunción ventricular::disfunción ventricular izquierda::miocardiopatía de Takotsubo; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico; COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::neurotransmisores::adrenérgicos::antagonistas adrenérgicos::antagonistas adrenérgicos beta; Otros calificadores::Otros calificadores::/uso terapéutico
Elsevier
Revista Portuguesa de Cardiologia;42(3)
https://doi.org/10.1016/j.repc.2022.02.010
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
Articles científics - HVH [3396]
