Statin therapy and outcome in Takotsubo syndrome patients: Results from the multicenter international GEIST registry

Several studies have shown that endothelial dysfunction plays a role in the pathogenesis of Takotsubo syndrome (TTS). Given the potential benefit of statin therapy on endothelial dysfunction, we hypothesized that such treatment could improve outcome. Aim of our study was to evaluate clinical charact...

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Detalles Bibliográficos
Autores: Novo, Giuseppina, Arcari, Luca, Stiermaier, Thomas, Alaimo, Chiara, El-Battrawy, Ibrahim, Cacciotti, Luca, Guerra, Federico, Musumeci, Beatrice, Mariano, Enrica, Parisi, Giuseppe, Montisci, Roberta, Vazirani, Ravi, Pérez-Castellanos, Alberto, Uribarri, Aitor, Corbí-Pascual, Miguel, Salamanca, Jorge, Akin, Ibrahim, Thiele, Holger, Brunetti, Natale Daniele, Eitel, Ingo, Núñez Gil, Iván J, Santoro, Francesco
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/20240
Acceso en línea:https://hdl.handle.net/20.500.13003/20240
Access Level:acceso abierto
Palabra clave:Prognosis
Aged, 80 and over
Male
Aged
Diabetes Mellitus
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Humans
Registries
Takotsubo Cardiomyopathy
Middle Aged
Inhibidores de Hidroximetilglutaril-CoA Reductasas
Humanos
Persona de Mediana Edad
Cardiomiopatía de Takotsubo
Pronóstico
Anciano
Anciano de 80 o más Años
Masculino
Sistema de Registros
Descripción
Sumario:Several studies have shown that endothelial dysfunction plays a role in the pathogenesis of Takotsubo syndrome (TTS). Given the potential benefit of statin therapy on endothelial dysfunction, we hypothesized that such treatment could improve outcome. Aim of our study was to evaluate clinical characteristics and outcome of TTS patients treated with statin therapy. Patients were enrolled in the international multicenter GEIST (GErman Italian Spanish Takotsubo) registry. Demographic data, clinical features and drug therapy at discharge were recorded. Primary study outcome was the occurrence of all-cause death at follow-up. Study population included 2429 consecutive TTS patients: 1293 (53.2%) discharged on statin and 1136 (46.8%) without statin. Patients with statin were older (age 72 ± 11 vs 69 ± 13 years, p < 0.001), with higher prevalence of hypertension (74.3% vs 60.3%, p < 0.001), diabetes (21.1% vs 14.7%, p < 0.001), dyslipidemia (56.1% vs 23.3%, p < 0.001), history of coronary artery disease (13.3% vs 6.3%, p < 0.001) and lower rates of in-hospital complications (14.7% vs 19.3%, p = 0.003). Survival analysis showed similar mortality rates between groups (log rank p = 0.803). At univariable analysis, statin therapy at discharge was not associated with lower mortality (HR: 0.97, 95% CI 0.74-1.26, p = 0.803). At multivariable analysis age (HR: 1.06 95% CI 1.04-1.08, p < 0.001), male sex (HR: 1.83, 95% CI 1.20-2.80, p = 0.005), diabetes (HR: 2.55, 95% CI 1.83-3.54 p < 0.001), malignancies (HR: 2.41, 95% CI 1.68-3.44, p < 0.001) and physical trigger (HR: 2.24, 95% CI 1.62-3.10, p < 0.001) were associated with increased mortality. Statin therapy after a TTS event was not associated with better prognosis at follow-up.

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