Association between treatment and MACE during follow-up in patients with Takotsubo syndrome

Takotsubo syndrome (TKS) is characterized by transient left ventricular (LV) dysfunction. Although it has traditionally been considered a benign condition, significant rates of complications and mortality have been observed during follow-up, and its long-term treatment remains poorly defined.

The aim of this study was to investigate differences in the occurrence of major adverse cardiovascular events (MACE) based on the treatment received at discharge and during follow-up in patients with TKS.

Data from the multicenter national registry on Takotsubo syndrome (RETAKO) were used. Baseline characteristics and treatment with ACE inhibitors, beta-blockers, and statins at discharge and during follow-up were collected. We defined MACE as patients experiencing recurrence of TKS, cardiovascular-related readmissions, and/or death during follow-up. Treatments received at discharge and during follow-up were compared with the occurrence of MACE, followed by a binary logistic regression adjusted for age, sex, and major risk factors.

A total of 1,573 patients were analyzed, with a mean age of 71 years, and 86.6% were women. At discharge, 57.2%, 60.6%, and 50% of patients were prescribed beta-blockers, ACE inhibitors/ARBs, and statins, respectively, while during follow-up, 15.8%, 17.7%, and 15.1% continued with beta-blockers, ACE inhibitors/ARBs, and statins, respectively. Statistically significant differences were found in the occurrence of MACE among the groups treated with beta-blockers and ACE inhibitors/ARBs at discharge. However, in multivariate analysis, no statistically significant differences were found in the occurrence of MACE during follow-up between treatment groups when adjusted for the variables included in the model.