Lack of Efficacy of Drug Therapy in Preventing Takotsubo Cardiomyopathy Recurrence: A Meta‐analysis

Clinical Cardiology - Tập 37 Số 7 - Trang 434-439 - 2014
Francesco Santoro1, Riccardo Ieva1, Francesco Musaico1, Armando Ferraretti1, G. Triggiani1, Nicola Tarantino1, Matteo Di Biase1, Natale Daniele Brunetti1
1Cardiology Department, University of Foggia, Foggia, Italy

Tóm tắt

AbstractBackgroundEfficacy 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.HypothesisThere is no evidence for preventing TTC recurrence by drug therapy.MethodsAfter a PubMed search, we conducted a meta‐analysis of available studies (clinical nonrandomized registries) on efficacy of drug therapy in preventing recurrence of TTC.ResultsA 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).ConclusionsA 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.

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Tài liệu tham khảo

10.1002/clc.22053

10.1161/CIRCULATIONAHA.106.677625

10.1056/NEJMoa043046

Dote K, 1991, Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases [article in Japanese], J Cardiol., 21, 203

10.1002/clc.22154

10.1016/j.jacc.2010.10.038

10.1378/chest.10-1041

10.1016/j.jacc.2009.08.057

10.1016/j.jacc.2007.03.050

10.1186/1741-7015-2-23

10.1016/j.ahj.2007.11.008

10.1136/bmjopen-2012-001165

Opolski G, 2010, Clinical presentation, treatment, and long‐term outcomes in patients with takotsubo cardiomyopathy: experience of a single cardiology center, Pol Arch Med Wewn., 120, 231

10.1002/clc.21986

10.1016/j.hlc.2011.11.010

10.1111/j.1445-5994.2011.02474.x

10.1016/j.ijcard.2008.01.026

10.1016/j.ijcard.2012.03.005

10.4330/wjc.v4.i6.211

10.1161/CIRCULATIONAHA.112.111591

10.1007/s003800300005

10.1016/j.ijcard.2012.03.111

10.1161/01.CIR.0000017187.61348.95

10.1002/clc.21983

10.1016/j.ijcard.2013.03.138

10.1111/1755-5922.12047

10.1253/circj.66.712

10.1016/j.jjcc.2012.01.017

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Clinical Cardiology

Tập 37 Số 7

434-439

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