1. Lack of efficacy of drug therapy in preventing takotsubo cardiomyopathy recurrence: a meta-analysis.
- Author
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Santoro F, Ieva R, Musaico F, Ferraretti A, Triggiani G, Tarantino N, Di Biase M, and Brunetti ND
- Subjects
- Humans, Odds Ratio, Recurrence, Risk Assessment, Risk Factors, Takotsubo Cardiomyopathy diagnosis, Time Factors, Treatment Outcome, Cardiovascular Agents therapeutic use, Secondary Prevention methods, Takotsubo Cardiomyopathy drug therapy
- Abstract
Background: Efficacy of chronic drug therapy in prevention of stress-induced cardiomyopathy recurrences is not well established. We therefore aimed to evaluate in this meta-analysis whether pharmacological treatment can effectively prevent takotsubo cardiomyopathy (TTC) recurrences, according to available studies., Hypothesis: There is no evidence for preventing TTC recurrence by drug therapy., Methods: After a PubMed search, we conducted a meta-analysis of available studies (clinical nonrandomized registries) on efficacy of drug therapy in preventing recurrence of TTC., Results: A total of 23 (4.5%) TTC recurrences occurred in the 511 patients included in the analysis. Seven studies on the effects of β-blockers on prevention of TTC recurrence were evaluated; the odds ratio (OR) was 0.44 and the 95% confidence interval (CI) was 0.15-1.31. In 5 studies on the effects of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, the OR was 0.42 and the 95% CI was 0.08-2.36; in 3 studies on statins, the OR was 0.74 and the 95% CI was 0.07-7.3; and in 4 studies on aspirin, the OR was 0.33 with a 95% CI of 0.05-2.17 (P value not significant in all cases)., Conclusions: A meta-analysis of the efficacy of different medications through the clinical TTC registries available showed no clinical evidence for a standard drug treatment in the chronic management of TTC. β-Blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, and aspirin do not seem to significantly reduce recurrences of TTC. Randomized, adequately powered studies are needed to further assess this issue., (© 2014 Wiley Periodicals, Inc.)
- Published
- 2014
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