Observational studyBMC cardiovascular disorders2017
Evaluation of therapy management and outcome in Takotsubo syndrome.
Observational study in BMC cardiovascular disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic impact of antiplatelet therapy in Takotsubo syndrome: a systematic review and meta-analysis of the literature.Heart failure reviews · 2022Pooled it
- Epidemiology, Pathophysiology, Diagnosis, and Principles of Management of Takotsubo Cardiomyopathy: A Review.Medical science monitor : international medical journal of experimental and clinical research · 2023Review
- Transient Mid-Ventricular Ballooning Syndrome: An Atypical Variant of Stress Cardiomyopathy.Cureus · 2023Article
- The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy-A Review.Journal of stroke · 2023Review
- The Octopus Trap of Takotsubo and Stroke: Genetics, Biomarkers and Clinical Management.Journal of personalized medicine · 2022Review
- Takotsubo Syndrome in the Emergency Room - Diagnostic Challenges and Suggested Algorithm.Reviews in cardiovascular medicine · 2022Review
- Update of Takotsubo cardiomyopathy: Present experience and outlook for the future.International journal of cardiology. Heart & vasculature · 2022Review
- "Broken Heart" and "Broken Brain": Which Connection?Cardiology research · 2022Article
- Transient Midventricular Ballooning Syndrome: An Atypical Case of Stress Cardiomyopathy.Cureus · 2021Article
- Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis.BMJ open · 2021Article
- Takotsubo Syndrome: Clinical Manifestations, Etiology and Pathogenesis.Current cardiology reviews · 2021Article
- Advancements in the diagnostic workup, prognostic evaluation, and treatment of takotsubo syndrome.Heart failure reviews · 2020Review
- A Review of the Evidence for Treatment of Myocardial Infarction With Nonobstructive Coronary Arteries.CJC open · 2020Review
- The Great Myocardial Mimic - Takotsubo Syndrome.Maedica · 2020Article
- Review
- Novel Aspects of Classification, Prognosis and Therapy in Takotsubo Syndrome.European cardiology · 2019Review
- Takotsubo cardiomyopathy in the intensive care unit.Acute medicine & surgery · 2019Article
- Impact of ST-segment elevation on the outcome of Takotsubo syndrome.Therapeutics and clinical risk management · 2019Article
- Takotsubo syndrome - adding pieces to a complex puzzle.BMC cardiovascular disorders · 2017Article
- Acute transient spinal paralysis and cardiac symptoms following an accidental epidural potassium infusion - a case report.BMC anesthesiology · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo date there is no validated evidence for standardized treatment of patients with Takotsubo syndrome (TTS). Medication therapy after final TTS diagnosis remains unclear. Previous data on patient outcome is ambivalent. Aim of this study was to evaluate medication therapy in TTS and to analyze patient outcome.
methodsWithin an observational retrospective cohort study we analyzed our medical records and included 72 patients with TTS that underwent cardiovascular magnetic resonance imaging (CMR) after a median of 2 days interquartile range (IQR 1-3.5). We investigated medication therapy at discharge. Medication implementation and major adverse clinical events (MACE) were prospectively evaluated after a median follow-up of 24 months (IQR 6-43). Left ventricular function, myocardial oedema and late gadolinium enhancement were analyzed in a CMR follow-up if available.
resultsAntithrombotic therapy was recommended in 69 (96%) patients including different combinations. Antiplatelet monotherapy was prescribed in 28 (39%) patients. Dual antiplatelet therapy was recommended in 29 (40%) patients. Length of therapy duration varied from one to twelve months. Only in one case oral anticoagulation was prescribed due to apical ballooning with a left ventricular ejection fraction <30%. In all other cases oral anticoagulation was recommended due to other indications. ß-adrenoceptor antagonists and ACE inhibitors were recommended in 63 (88%), mineralocorticoid receptor antagonists were prescribed in 31 (43%) patients. After a median of 2 months (IQR 1.3-2.9) left ventricular function significantly recovered (49.1% ± 10.1 vs. 64.1% ± 5.7, P < 0.001) and myocardial oedema significantly decreased (13.5 ± 11.3 vs. 0.6% ± 2.4, P = <0.001) in the CMR follow-up. The 30-day mortality was 1%. MACE rate after 24 months was 12%.
conclusionAlthough therapy guidelines for TTS currently do not exist, we found that the majority of patients were treated with antithrombotic and heart failure therapy for up to twelve months. Left ventricular function and myocardial oedema recovered rapidly within the first two months. Outcome analysis showed a low bleeding rate and a high short-term survival. Therefore, TTS patients might benefit from antithrombotic and heart failure therapy at least for the first two months.
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