Impact of aspirin on takotsubo syndrome: a propensity score‐based analysis of the InterTAK Registry
Authors: D'Ascenzo Fabrizio , Gili Sebastiano , Bertaina Maurizio , Iannaccone Mario , Cammann Victoria L. , Di Vece Davide , Kato Ken , Saglietto Andrea , Szawan Konrad A. , Frangieh Antonio H. , Boffini Beatrice , Annaratone Margherita , Sarcon Annahita , Levinson Rena A. , Franke Jennifer , Napp L. Christian , Jaguszewski Milosz , Noutsias Michel , Münzel Thomas , Knorr Maike , Heiner Susanne , Katus Hugo A. , Burgdorf Christof , Schunkert Heribert , Thiele Holger , Bauersachs Johann , Tschöpe Carsten , Pieske Burkert M. , Rajan Lawrence , Michels Guido , Pfister Roman , Cuneo Alessandro , Jacobshagen Claudius , Hasenfuß Gerd , Karakas Mahir , Koenig Wolfgang , Rottbauer Wolfgang , Said Samir M. , Braun‐Dullaeus Ruediger C. , Banning Adrian , Cuculi Florim , Kobza Richard , Fischer Thomas A. , Vasankari Tuija , Airaksinen K.E. Juhani , Opolski Grzegorz , Dworakowski Rafal , MacCarthy Philip , Kaiser Christoph , Osswald Stefan , Galiuto Leonarda , Crea Filippo , Dichtl Wolfgang , Franz Wolfgang M. , Empen Klaus , Felix Stephan B. , Delmas Clément , Lairez Olivier , El‐Battrawy Ibrahim , Akin Ibrahim , Borggrefe Martin , Horowitz John D. , Kozel Martin , Tousek Petr , Widimský Petr , Gilyarova Ekaterina , Shilova Alexandra , Gilyarov Mikhail , Biondi‐Zoccai Giuseppe , Winchester David E. , Ukena Christian , Neuhaus Michael , Bax Jeroen J. , Prasad Abhiram , Di Mario Carlo , Böhm Michael , Gasparini Mauro , Ruschitzka Frank , Bossone Eduardo , Citro Rodolfo , Rinaldi Mauro , De Ferrari Gaetano Maria , Lüscher Thomas , Ghadri Jelena R. , Templin Christian 
Published: December 2019

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.