Evidence map›Paper›PMID 40357262›Full record

ArticleEuropean heart journal open2025

Survival benefit of secondary prevention medical therapy in takotsubo cardiomyopathy: a Bayesian network meta-analysis.

Daud Mutahar, Ammar Zaka, Stephen Bacchi, Brandon Stretton, Joshua G Kovoor, Aashray K Gupta, Naim Mridha

Abstract read
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Article in European heart journal open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Daud MutaharFaculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD 4216, Australia.ORCID https://orcid.org/0009-0006-4056-7097
Ammar ZakaDepartment of Cardiology, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia.ORCID https://orcid.org/0009-0004-4513-9601
Stephen BacchiMassachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA.ORCID https://orcid.org/0000-0001-5130-8628
Brandon StrettonRoyal Adelaide Hospital, Port Rd, Adelaide, SA 5000, Australia.ORCID https://orcid.org/0000-0002-7939-3489
Joshua G KovoorDepartment of Cardiology, Westmead Hospital, Cnr Hawkesbury Road and Darcy Road, Westmead, NSW 2145, Australia.
Aashray K GuptaRoyal North Shore Hospital, Reserve Rd, St Leonards, NSW 2065, Australia.
Naim MridhaDepartment of Cardiology, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Takotsubo cardiomyopathy (TTC) is a form of transient left ventricular systolic dysfunction without evidence of complicated coronary artery disease. Efficacy of medical therapy in secondary prevention of all-cause mortality is not well established. We performed a systematic review and network meta-analysis to compare survival benefit of secondary prevention medical therapy in patients with TTC. Methods and results: PubMed, Embase, and Cochrane were searched up to 6 January 2024. Eligible studies included multivariable-adjusted or propensity-matched studies of patients receiving medical therapy with beta-blockers, angiotensin-converting enzyme inhibitors (ACE) or angiotensin receptor blockers (ARBs), aspirin, and statins after an index presentation with TTC. The primary outcome was all-cause mortality at any time point. Secondary outcome was TTC recurrence. Random-effect hierarchical Bayesian meta-analysis was performed. We identified 13 observational studies. Takotsubo cardiomyopathy mortality was reported in 435 (4.7%) out of 9237 patients, across a median follow-up of 2.18 years. Mean age was 69.7 ± 12.5 years, and 7906 patients (90.7%) were females. Beta-blockers were associated with a statistically significant reduction in mortality compared to control [hazard ratio (HR) 0.65, 95% confidence interval (CI) (0.55-0.77)]. ACE inhibitors/ARBs showed a nonsignificant trend towards mortality reduction [HR 0.76, 95% CI (0.54-1.07)]. Statins [HR 0.96, 95% CI (0.77-1.19)] and aspirin [HR 0.87, 95% CI (0.55-1.38)] showed no significant mortality benefit. Bayesian probability ranks favoured beta-blockers as the most effective treatment for TTC mortality prevention. Conclusion: This review highlights the modest efficacy of secondary prevention medications in the management of TTC, as ACE or ARBs, beta-blockers, aspirin, and statins failed to demonstrate comparative mortality benefit. Randomized controlled trials are needed to confirm efficacy of pharmacotherapy in this vulnerable patient cohort.

Indexed as

Acute coronary syndromeHeart failurePharmacotherapyTakotsubo cardiomyopathy

Identifiers

PMID40357262
PMCPMC12066946

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.