Among patients with takotsubo syndrome (TTS), beta-blocker therapy was associated with lower follow-up mortality but not lower TTS recurrence, according to a study published Feb. 5 in JACC: Heart Failure.

The study included 2,853 patients discharged from the hospital with a confirmed TTS diagnosis and enrolled in the international multicenter GErman Italian Spanish Takotsubo (GEIST) registry. Using propensity score matching, Sergio Raposeiras-Roubin, MD, PhD, et al., compared two groups of 697 patients separated by whether they received beta-blocker therapy at discharge.

Overall, 485 patients (17%) died and 97 (3.4%) experienced TTS recurrence over a mean follow-up period of 2.6 years. Those treated with beta-blockers at discharge (n=2,125) exhibited a lower mortality rate when compared with those who did not receive beta-blocker therapy (6.0 vs. 8.1 per 100 patients/year).

Following propensity score matching, the mortality rate during follow-up was lower among patients in the beta-blocker therapy group (hazard ratio [HR], 0.71; 95% CI, 0.55-0.90), especially within the first year post discharge.

According to the authors, no differences were observed among subgroups. "A possible favorable differential effect in patients with hypertension or cardiogenic shock was not found, in contrast to what was previously hypothesized in other studies."

There was no lower rate of TTS recurrence among the beta-blocker therapy group during follow-up (HR, 0.74, 95% CI, 0.61-1.89), and no association was identified between use of beta-blockers at discharge and LVEF recovery.

"Beta-blockers were associated with a significantly higher long-term survival but not with lower TTS recurrence," write the authors. "These findings provide favorable scientific evidence to develop clinical trials that confirm the causal relationship between beta-blocker therapy and mortality reduction."