Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry

TY - JOUR

T1 - Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry

AU - D'Ascenzo, Fabrizio

AU - Gili, Sebastiano

AU - Bertaina, Maurizio

AU - Iannaccone, Mario

AU - Cammann, Victoria L

AU - Di Vece, Davide

AU - Kato, Ken

AU - Saglietto, Andrea

AU - Szawan, Konrad A

AU - Frangieh, Antonio H

AU - Boffini, Beatrice

AU - Annaratone, Margherita

AU - Sarcon, Annahita

AU - Levinson, Rena A

AU - Franke, Jennifer

AU - Napp, L Christian

AU - Jaguszewski, Milosz

AU - Noutsias, Michel

AU - Münzel, Thomas

AU - Knorr, Maike

AU - Heiner, Susanne

AU - Katus, Hugo A

AU - Burgdorf, Christof

AU - Schunkert, Heribert

AU - Thiele, Holger

AU - Bauersachs, Johann

AU - Tschöpe, Carsten

AU - Pieske, Burkert M

AU - Rajan, Lawrence

AU - Michels, Guido

AU - Pfister, Roman

AU - Cuneo, Alessandro

AU - Jacobshagen, Claudius

AU - Hasenfuß, Gerd

AU - Karakas, Mahir

AU - Koenig, Wolfgang

AU - Rottbauer, Wolfgang

AU - Said, Samir M

AU - Braun-Dullaeus, Ruediger C

AU - Banning, Adrian

AU - Cuculi, Florim

AU - Kobza, Richard

AU - Fischer, Thomas A

AU - Vasankari, Tuija

AU - Airaksinen, K E Juhani

AU - Opolski, Grzegorz

AU - Dworakowski, Rafal

AU - MacCarthy, Philip

AU - Kaiser, Christoph

AU - Osswald, Stefan

AU - Galiuto, Leonarda

AU - Crea, Filippo

AU - Dichtl, Wolfgang

AU - Franz, Wolfgang M

AU - Empen, Klaus

AU - Felix, Stephan B

AU - Delmas, Clément

AU - Lairez, Olivier

AU - El-Battrawy, Ibrahim

AU - Akin, Ibrahim

AU - Borggrefe, Martin

AU - Horowitz, John D

AU - Kozel, Martin

AU - Tousek, Petr

AU - Widimský, Petr

AU - Gilyarova, Ekaterina

AU - Shilova, Alexandra

AU - Gilyarov, Mikhail

AU - Biondi-Zoccai, Giuseppe

AU - Winchester, David E

AU - Ukena, Christian

AU - Neuhaus, Michael

AU - Bax, Jeroen J

AU - Prasad, Abhiram

AU - Di Mario, Carlo

AU - Böhm, Michael

AU - Gasparini, Mauro

AU - Ruschitzka, Frank

AU - Bossone, Eduardo

AU - Citro, Rodolfo

AU - Rinaldi, Mauro

AU - De Ferrari, Gaetano Maria

AU - Lüscher, Thomas

AU - Ghadri, Jelena R

AU - Templin, Christian

N1 - © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology.

PY - 2020/2/1

Y1 - 2020/2/1

N2 - AIMS: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS).METHODS AND RESULTS: Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50-3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78-1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting.CONCLUSION: In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621.

AB - AIMS: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS).METHODS AND RESULTS: Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50-3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78-1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting.CONCLUSION: In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621.

KW - Aspirin/therapeutic use

KW - Heart Failure

KW - Humans

KW - Ischemic Attack, Transient

KW - Myocardial Infarction

KW - Platelet Aggregation Inhibitors/therapeutic use

KW - Propensity Score

KW - Recurrence

KW - Registries

KW - Stroke

KW - Takotsubo Cardiomyopathy/drug therapy

KW - Treatment Outcome

U2 - 10.1002/ejhf.1698

DO - 10.1002/ejhf.1698

M3 - SCORING: Journal article

C2 - 31863563

VL - 22

SP - 330

EP - 337

JO - EUR J HEART FAIL

JF - EUR J HEART FAIL

SN - 1388-9842

IS - 2

ER -