Fabrizio D'Ascenzo1, Sebastiano Gili2, Maurizio Bertaina1, Mario Iannaccone1, Victoria L Cammann3, Davide Di Vece3, Ken Kato3, Andrea Saglietto1, Konrad A Szawan3, Antonio H Frangieh4,5, Beatrice Boffini2, Margherita Annaratone6, Annahita Sarcon7, Rena A Levinson3,8, Jennifer Franke9, L Christian Napp10, Milosz Jaguszewski11, Michel Noutsias12, Thomas Münzel13, Maike Knorr13, Susanne Heiner13, Hugo A Katus9, Christof Burgdorf14, Heribert Schunkert4,5, Holger Thiele15, Johann Bauersachs10, Carsten Tschöpe16, Burkert M Pieske16, Lawrence Rajan17, Guido Michels18, Roman Pfister18, Alessandro Cuneo19, Claudius Jacobshagen20, Gerd Hasenfuß20, Mahir Karakas21,22, Wolfgang Koenig4,5, Wolfgang Rottbauer23, Samir M Said24, Ruediger C Braun-Dullaeus24, Adrian Banning25, Florim Cuculi26, Richard Kobza26, Thomas A Fischer27, Tuija Vasankari28, K E Juhani Airaksinen28, Grzegorz Opolski29, Rafal Dworakowski30, Philip MacCarthy30, Christoph Kaiser31, Stefan Osswald31, Leonarda Galiuto32, Filippo Crea32, Wolfgang Dichtl33, Wolfgang M Franz33, Klaus Empen34,35, Stephan B Felix34,35, Clément Delmas36, Olivier Lairez36, Ibrahim El-Battrawy37,38, Ibrahim Akin37,38, Martin Borggrefe37,38, John D Horowitz39, Martin Kozel40, Petr Tousek40, Petr Widimský40, Ekaterina Gilyarova41, Alexandra Shilova41, Mikhail Gilyarov41, Giuseppe Biondi-Zoccai42, David E Winchester43, Christian Ukena44, Michael Neuhaus45, Jeroen J Bax46, Abhiram Prasad47, Carlo Di Mario48, Michael Böhm44, Mauro Gasparini6, Frank Ruschitzka3, Eduardo Bossone49, Rodolfo Citro50, Mauro Rinaldi1, Gaetano Maria De Ferrari51, Thomas Lüscher52,53, Jelena R Ghadri3, Christian Templin3. 1. Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy. 2. Centro Cardiologico Monzino, IRCCS, Milan, Italy. 3. Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. 4. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. 5. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 6. Department of Mathematical Sciences, Politecnico di Torino, Turin, Italy. 7. Section of Cardiac Electrophysiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA. 8. Division of Biological Sciences, University of California San Diego, San Diego, CA, USA. 9. Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany. 10. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. 11. First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland. 12. Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Halle, Germany. 13. Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany. 14. Heart and Vascular Centre Bad Bevensen, Bad Bevensen, Germany. 15. Department of Internal Medicine/Cardiology, Heart Center Leipzig - University Hospital, Leipzig, Germany. 16. Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany. 17. TJ Health Partners Heart and Vascular, Glasgow, KY, USA. 18. Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany. 19. Krankenhaus "Maria Hilf" Medizinische Klinik, Stadtlohn, Germany. 20. Clinic for Cardiology and Pneumology, Georg August University Goettingen, Goettingen, Germany. 21. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. 22. DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany. 23. Department of Internal Medicine II - Cardiology, University of Ulm, Medical Center, Ulm, Germany. 24. Internal Medicine/Cardiology, Angiology, and Pneumology, Magdeburg University, Magdeburg, Germany. 25. Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK. 26. Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland. 27. Department of Cardiology, Kantonsspital Winterthur, Winterthur, Switzerland. 28. Heart Center, Turku University Hospital and University of Turku, Turku, Finland. 29. Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. 30. Department of Cardiology, Kings College Hospital, Kings Health Partners, London, UK. 31. Department of Cardiology, University Hospital Basel, Basel, Switzerland. 32. Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 33. University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria. 34. Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany. 35. DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany. 36. Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France. 37. First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM) University of Heidelberg, Mannheim, Germany. 38. DZHK (German Center for Cardiovascular Research), partner site, Heidelberg-Mannheim, Mannheim, Germany. 39. Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia. 40. Cardiocenter, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady, Prague, Czech Republic. 41. Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov, Moscow, Russia. 42. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. 43. Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. 44. Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg, Germany. 45. Department of Cardiology, Kantonsspital Frauenfeld, Frauenfeld, Switzerland. 46. Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands. 47. Division of Cardiovascular Diseases Mayo Clinic, Rochester, MN, USA. 48. Structural Interventional Cardiology, University Hospital Careggi, Florence, Italy. 49. Division of Cardiology, 'Antonio Cardarelli' Hospital, Naples, Italy. 50. Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy. 51. Department of Molecular Medicine University of Pavia, and Cardiac Intensive Care Unit and Laboratories for Experimental Cardiology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy. 52. Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Zurich, Switzerland. 53. Royal Brompton and Harefield Hospitals Trust and Imperial College, London, UK.
Abstract
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.
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 TTSpatients 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 TTSpatients 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.
Authors: Razvan I Radu; Tuvia Ben Gal; Magdy Abdelhamid; Elena-Laura Antohi; Marianna Adamo; Andrew P Ambrosy; Oliviana Geavlete; Yuri Lopatin; Alexander Lyon; Oscar Miro; Marco Metra; John Parissis; Sean P Collins; Stefan D Anker; Ovidiu Chioncel Journal: ESC Heart Fail Date: 2021-10-19
Authors: Anastasiia V Bairashevskaia; Sofiya Y Belogubova; Mikhail R Kondratiuk; Daria S Rudnova; Susanna S Sologova; Olga I Tereshkina; Esma I Avakyan Journal: Int J Cardiol Heart Vasc Date: 2022-03-07