Lack of efficacy of drug therapy in preventing takotsubo cardiomyopathy recurrence: a meta-analysis.

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.

• Authors: Francesco Santoro, Riccardo Ieva, Francesco Musaico, Armando Ferraretti, Giuseppe Triggiani, Nicola Tarantino, Matteo Di Biase, Natale Daniele Brunetti
• Journal: Clinical cardiology (Clin Cardiol) Vol. 37 Issue 7 Pg. 434-9 (Jul 2014) ISSN: 1932-8737 [Electronic] United States
• PMID: 24700369 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: © 2014 Wiley Periodicals, Inc.

Chemical References

• Cardiovascular Agents

Topics

• Cardiovascular Agents (therapeutic use)
• Humans
• Odds Ratio
• Recurrence
• Risk Assessment
• Risk Factors
• Secondary Prevention (methods)
• Takotsubo Cardiomyopathy (diagnosis, drug therapy)
• Time Factors
• Treatment Outcome