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

Fabrizio D'Ascenzo; Francesca D'Ascenzo; Sebastiano Gili; Maurizio Bertaina; Mario Iannaccone; Victoria L. Cammann; Davide Di Vece; Ken Kato; Andrea Saglietto; Konrad A. Szawan; Antonio H. Frangieh; Beatrice Boffini; Margherita Annaratone; Annahita Sarcon; Rena A. Levinson; Jennifer Franke; L. Christian Napp; Milosz Jaguszewski; Michel Noutsias; Thomas Münzel; Maike Knorr; Susanne Heiner; Hugo A. Katus; Christof Burgdorf; Heribert Schunkert; Holger Thiele; Johann Bauersachs; Carsten Tschöpe; Burkert M. Pieske; Lawrence Rajan; Guido Michels; Roman Pfister; Alessandro Cuneo; Claudius Jacobshagen; Gerd Hasenfuß; Mahir Karakas; Wolfgang Koenig; Wolfgang Rottbauer; Samir M. Said; Ruediger C. Braun-Dullaeus; Adrian Banning; Florim Cuculi; Richard Kobza; Thomas A. Fischer; Tuija Vasankari; K.E. Juhani Airaksinen; Grzegorz Opolski; Rafal Dworakowski; Philip Maccarthy; Christoph Kaiser; Stefan Osswald; Leonarda Galiuto; Filippo Crea; Wolfgang Dichtl; Wolfgang M. Franz; Klaus Empen; Stephan B. Felix; Clément Delmas; Olivier Lairez; Ibrahim El-Battrawy; Ibrahim Akin; Martin Borggrefe; John D. Horowitz; Martin Kozel; Petr Tousek; Petr Widimský; Ekaterina Gilyarova; Alexandra Shilova; Mikhail Gilyarov; Giuseppe Biondi-Zoccai; David E. Winchester; Christian Ukena; Michael Neuhaus; Jeroen J. Bax; Abhiram Prasad; Carlo Di Mario; Michael Böhm; Mauro Gasparini; Frank Ruschitzka; Eduardo Bossone; Rodolfo Citro; Mauro Rinaldi; Gaetano Maria De Ferrari; Thomas Lüscher; Jelena R. Ghadri; Christian Templin

doi:10.1002/ejhf.1698

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

Fabrizio D'Ascenzo, Francesca D'Ascenzo, Sebastiano Gili, Maurizio Bertaina, Mario Iannaccone, Victoria L. Cammann, Davide Di Vece, Ken Kato, Andrea Saglietto, Konrad A. Szawan, Antonio H. Frangieh, Beatrice Boffini, Margherita Annaratone, Annahita Sarcon, Rena A. Levinson, Jennifer Franke, L. Christian Napp, Milosz Jaguszewski, Michel Noutsias, Thomas MünzelMaike Knorr, Susanne Heiner, Hugo A. Katus, Christof Burgdorf, Heribert Schunkert, Holger Thiele, Johann Bauersachs, Carsten Tschöpe, Burkert M. Pieske, Lawrence Rajan, Guido Michels, Roman Pfister, Alessandro Cuneo, Claudius Jacobshagen, Gerd Hasenfuß, Mahir Karakas, Wolfgang Koenig, Wolfgang Rottbauer, Samir M. Said, Ruediger C. Braun-Dullaeus, Adrian Banning, Florim Cuculi, Richard Kobza, Thomas A. Fischer, Tuija Vasankari, K.E. Juhani Airaksinen, Grzegorz Opolski, Rafal Dworakowski, Philip Maccarthy, Christoph Kaiser, Stefan Osswald, Leonarda Galiuto, Filippo Crea, Wolfgang Dichtl, Wolfgang M. Franz, Klaus Empen, Stephan B. Felix, Clément Delmas, Olivier Lairez, Ibrahim El-Battrawy, Ibrahim Akin, Martin Borggrefe, John D. Horowitz, Martin Kozel, Petr Tousek, Petr Widimský, Ekaterina Gilyarova, Alexandra Shilova, Mikhail Gilyarov, Giuseppe Biondi-Zoccai, David E. Winchester, Christian Ukena, Michael Neuhaus, Jeroen J. Bax, Abhiram Prasad, Carlo Di Mario, Michael Böhm, Mauro Gasparini, Frank Ruschitzka, Eduardo Bossone, Rodolfo Citro, Mauro Rinaldi, Gaetano Maria De Ferrari, Thomas Lüscher, Jelena R. Ghadri, Christian Templin

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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.

Original language	English
Pages (from-to)	330-337
Number of pages	8
Journal	European Journal of Heart Failure
Volume	22
DOIs	https://doi.org/10.1002/ejhf.1698
Publication status	Published - 2020

Keywords

Acute heart failure
Aspirin
Medical therapy
Outcome
Takotsubo syndrome

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10.1002/ejhf.1698

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D'Ascenzo, F., D'Ascenzo, F., Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Kato, K., Saglietto, A., Szawan, K. A., Frangieh, A. H., Boffini, B., Annaratone, M., Sarcon, A., Levinson, R. A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., ... Templin, C. (2020). Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry. European Journal of Heart Failure, 22, 330-337. https://doi.org/10.1002/ejhf.1698

@article{d07ff3bf2cf7448c8901b04bb54cf9ab,

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

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.",

keywords = "Acute heart failure, Aspirin, Medical therapy, Outcome, Takotsubo syndrome, Acute heart failure, Aspirin, Medical therapy, Outcome, Takotsubo syndrome",

author = "Fabrizio D'Ascenzo and Francesca D'Ascenzo and Sebastiano Gili and Maurizio Bertaina and Mario Iannaccone and Cammann, {Victoria L.} and {Di Vece}, Davide and Ken Kato and Andrea Saglietto and Szawan, {Konrad A.} and Frangieh, {Antonio H.} and Beatrice Boffini and Margherita Annaratone and Annahita Sarcon and Levinson, {Rena A.} and Jennifer Franke and Napp, {L. Christian} and Milosz Jaguszewski and Michel Noutsias and Thomas M{\"u}nzel and Maike Knorr and Susanne Heiner and Katus, {Hugo A.} and Christof Burgdorf and Heribert Schunkert and Holger Thiele and Johann Bauersachs and Carsten Tsch{\"o}pe and Pieske, {Burkert M.} and Lawrence Rajan and Guido Michels and Roman Pfister and Alessandro Cuneo and Claudius Jacobshagen and Gerd Hasenfu{\ss} and Mahir Karakas and Wolfgang Koenig and Wolfgang Rottbauer and Said, {Samir M.} and Braun-Dullaeus, {Ruediger C.} and Adrian Banning and Florim Cuculi and Richard Kobza and Fischer, {Thomas A.} and Tuija Vasankari and Airaksinen, {K.E. Juhani} and Grzegorz Opolski and Rafal Dworakowski and Philip Maccarthy and Christoph Kaiser and Stefan Osswald and Leonarda Galiuto and Filippo Crea and Wolfgang Dichtl and Franz, {Wolfgang M.} and Klaus Empen and Felix, {Stephan B.} and Cl{\'e}ment Delmas and Olivier Lairez and Ibrahim El-Battrawy and Ibrahim Akin and Martin Borggrefe and Horowitz, {John D.} and Martin Kozel and Petr Tousek and Petr Widimsk{\'y} and Ekaterina Gilyarova and Alexandra Shilova and Mikhail Gilyarov and Giuseppe Biondi-Zoccai and Winchester, {David E.} and Christian Ukena and Michael Neuhaus and Bax, {Jeroen J.} and Abhiram Prasad and {Di Mario}, Carlo and Michael B{\"o}hm and Mauro Gasparini and Frank Ruschitzka and Eduardo Bossone and Rodolfo Citro and Mauro Rinaldi and {De Ferrari}, {Gaetano Maria} and Thomas L{\"u}scher and Ghadri, {Jelena R.} and Christian Templin",

year = "2020",

doi = "10.1002/ejhf.1698",

language = "English",

volume = "22",

pages = "330--337",

journal = "European Journal of Heart Failure",

issn = "1388-9842",

publisher = "John Wiley and Sons Ltd",

}

D'Ascenzo, F, D'Ascenzo, F, Gili, S, Bertaina, M, Iannaccone, M, Cammann, VL, Di Vece, D, Kato, K, Saglietto, A, Szawan, KA, Frangieh, AH, Boffini, B, Annaratone, M, Sarcon, A, Levinson, RA, Franke, J, Napp, LC, Jaguszewski, M, Noutsias, M, Münzel, T, Knorr, M, Heiner, S, Katus, HA, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschöpe, C, Pieske, BM, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuß, G, Karakas, M, Koenig, W, Rottbauer, W, Said, SM, Braun-Dullaeus, RC, Banning, A, Cuculi, F, Kobza, R, Fischer, TA, Vasankari, T, Airaksinen, KEJ, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Franz, WM, Empen, K, Felix, SB, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Horowitz, JD, Kozel, M, Tousek, P, Widimský, P, Gilyarova, E, Shilova, A, Gilyarov, M, Biondi-Zoccai, G, Winchester, DE, Ukena, C, Neuhaus, M, Bax, JJ, Prasad, A, Di Mario, C, Böhm, M, Gasparini, M, Ruschitzka, F, Bossone, E, Citro, R, Rinaldi, M, De Ferrari, GM, Lüscher, T, Ghadri, JR & Templin, C 2020, 'Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry', European Journal of Heart Failure, vol. 22, pp. 330-337. https://doi.org/10.1002/ejhf.1698

TY - JOUR

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

AU - D'Ascenzo, Fabrizio

AU - D'Ascenzo, Francesca

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

PY - 2020

Y1 - 2020

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 - Acute heart failure

KW - Aspirin

KW - Medical therapy

KW - Outcome

KW - Takotsubo syndrome

KW - Acute heart failure

KW - Aspirin

KW - Medical therapy

KW - Outcome

KW - Takotsubo syndrome

UR - http://hdl.handle.net/10807/166998

U2 - 10.1002/ejhf.1698

DO - 10.1002/ejhf.1698

M3 - Article

SN - 1388-9842

VL - 22

SP - 330

EP - 337

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

ER -

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

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