Abstract 15644: A Systematic Review and Meta-Analysis Exploring Impact of Beta-Blocker Therapy on Long Term Mortality in Takotsubo Cardiomyopathy

Introduction: Conflicting data exist regarding the effects of beta-blocker (BB) therapy on long-term survival in Takotsubo cardiomyopathy (TC). This study aims to address this gap by examining the potential impact of BB therapy on long-term mortality in patients with TC.

Methods: We searched Pubmed (MEDLINE), Google Scholar, and EMBASE for relevant studies from inception to May 18 ^th , 2023. We included observational studies reporting the impact of BB use on all-cause mortality during long-term follow-up in patients with TC. Hazard ratios (HRs) of all-cause mortality with their 95% confidence interval (CI) for beta-blocker use were extracted. Study-specific estimates were pooled using an inverse-variance, random-effects model.

Results: We identified seven eligible studies enrolling 3,446 patients with TC with a mean follow-up duration of up to 5.8 years. The primary meta-analysis for long-term all-cause mortality combining all HRs showed significant long-term mortality reduction with BB use (HR=0.62; 95%CI [0.50-0.79], P<0.0001, I ² =10%). Similarly, pooled analysis of adjusted HRs for long-term all-cause mortality demonstrated improved survival with BB therapy (HR=0.61; 95%CI [0.43-0.88], P=0.008, I ² =33%) (Figure 1).

Conclusions: Observational data suggest that the use of BB therapy is associated with a significant improvement in long-term survival in patients with TC. Randomized control trials should be performed to evaluate this effect further.