Treating a broken heart: Beta-blockers improve survival in patients with takotsubo syndrome
Using beta-blocker therapy to treat patients with takotsubo syndrome (TTS) is associated with a significant improvement in long-term mortality, according to new findings published in JACC: Heart Failure.[1]
TTS, commonly known as “broken heart syndrome,” is a rare, potentially fatal heart condition that often presents as sudden chest pain or the onset of a heart attack. It can lead to heart failure, arrhythmias and other significant complications. TTS is often treated as if it was heart failure, researchers noted, but the optimal clinical approach remains a bit of a mystery.
“Given the pathophysiological role of catecholamines in TTS, it seems logical to think that beta-blockers could be useful in those patients.,” wrote first author Sergio Raposeiras-Roubin MD, PhD, a cardiologist with Álvaro Cunqueiro Hospital in Spain, and colleagues. “However, the evidence about its usefulness is doubtful, with contradictory results in small observational studies. Therefore, further studies are needed to clarify whether beta-blockers are actually useful or not in patients with TTS. The present study aims to specifically analyze the impact of medical therapy with beta-blockers at discharge in the long-term prognosis of patients with TTS in one of the largest TTS cohorts to date.”
Raposeiras-Roubin et al. tracked data from more than 2,800 patients with a confirmed diagnosis of TTS. All patients were treated in Spain, Italy or Germany from 2002 to 2022, and nearly 71% were given beta-blocker therapy to help their TTS.
After a mean follow-up period of 2.6 years, mortality was seen in 17% of patients and TTS recurrence was seen in 3.4%. The mortality rates were 6 per 100 patients/year for patients treated with beta-blockers and 8.1 per 100 patients/year for patients who did not receive beta-blockers.
Propensity score matching (PSM) left the group with two pairs of 697 patients—each pair included one patient who did undergo beta-blocker therapy and a second patient who did not. Overall, the PSM analysis confirmed that beta-blockers were linked to a reduction in long-term mortality, primarily in the first year. There was no difference, however, in TTS recurrence or left ventricle ejection fraction when comparing the two groups.
“These findings provide favorable scientific evidence to develop clinical trials that confirm the causal relationship between beta-blocker therapy and mortality reduction,” the authors wrote.
Click here to read the full study in JACC: Heart Failure, an American College of Cardiology journal.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.