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Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry.
European Journal of Heart Failure ( IF 16.9 ) Pub Date : 2019-12-20 , DOI: 10.1002/ejhf.1698
Fabrizio D'Ascenzo 1 , Sebastiano Gili 2 , Maurizio Bertaina 1 , Mario Iannaccone 1 , Victoria L Cammann 3 , Davide Di Vece 3 , Ken Kato 3 , Andrea Saglietto 1 , Konrad A Szawan 3 , Antonio H Frangieh 4, 5 , Beatrice Boffini 2 , Margherita Annaratone 6 , Annahita Sarcon 7 , Rena A Levinson 3, 8 , Jennifer Franke 9 , L Christian Napp 10 , Milosz Jaguszewski 11 , Michel Noutsias 12 , Thomas Münzel 13 , Maike Knorr 13 , Susanne Heiner 13 , Hugo A Katus 9 , Christof Burgdorf 14 , Heribert Schunkert 4, 5 , Holger Thiele 15 , Johann Bauersachs 10 , Carsten Tschöpe 16 , Burkert M Pieske 16 , Lawrence Rajan 17 , Guido Michels 18 , Roman Pfister 18 , Alessandro Cuneo 19 , Claudius Jacobshagen 20 , Gerd Hasenfuß 20 , Mahir Karakas 21, 22 , Wolfgang Koenig 4, 5 , Wolfgang Rottbauer 23 , Samir M Said 24 , Ruediger C Braun-Dullaeus 24 , Adrian Banning 25 , Florim Cuculi 26 , Richard Kobza 26 , Thomas A Fischer 27 , Tuija Vasankari 28 , K E Juhani Airaksinen 28 , Grzegorz Opolski 29 , Rafal Dworakowski 30 , Philip MacCarthy 30 , Christoph Kaiser 31 , Stefan Osswald 31 , Leonarda Galiuto 32 , Filippo Crea 32 , Wolfgang Dichtl 33 , Wolfgang M Franz 33 , Klaus Empen 34, 35 , Stephan B Felix 34, 35 , Clément Delmas 36 , Olivier Lairez 36 , Ibrahim El-Battrawy 37, 38 , Ibrahim Akin 37, 38 , Martin Borggrefe 37, 38 , John D Horowitz 39 , Martin Kozel 40 , Petr Tousek 40 , Petr Widimský 40 , Ekaterina Gilyarova 41 , Alexandra Shilova 41 , Mikhail Gilyarov 41 , Giuseppe Biondi-Zoccai 42 , David E Winchester 43 , Christian Ukena 44 , Michael Neuhaus 45 , Jeroen J Bax 46 , Abhiram Prasad 47 , Carlo Di Mario 48 , Michael Böhm 44 , Mauro Gasparini 6 , Frank Ruschitzka 3 , Eduardo Bossone 49 , Rodolfo Citro 50 , Mauro Rinaldi 1 , Gaetano Maria De Ferrari 51 , Thomas Lüscher 52, 53 , Jelena R Ghadri 3 , Christian Templin 3
Affiliation  

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.

中文翻译:

阿司匹林对takotsubo综合征的影响:InterTAK注册中心基于倾向评分的分析。

目的本研究的目的是研究阿司匹林对takotsubo综合征(TTS)预后的影响。方法和结果根据出院时使用阿司匹林的处方,将来自国际Takotsubo(InterTAK)登记处的患者分为两组。使用调整后的倾向得分(PS)分层分析对两组之间的临床结局进行比较。还报告了未经调整的分析结果,以注意PS调整的效果。在30天和5年的随访中评估了主要的不良心脏和脑血管事件(MACCE:死亡,心肌梗死,TTS复发,中风或短暂性脑缺血发作的综合症状)。总共包括1533名在出院时了解阿司匹林处方状态的TTS患者。根据基于PS分层的调整后分析,在30天时,阿司匹林与MACCE的较低危险性无关[危险比(HR)1.24,95%置信区间(CI)0.50-3.04,P = 0.64]或5年随访(HR 1.11,95%CI 0.78-1.58,P = 0.58)。这些结果通过使用基于PS的替代方法进行的敏感性分析得到了证实,即协变量调整和治疗加权的逆概率。结论在本研究中,在TTS患者中使用阿司匹林与30天和5年随访时MACCE风险降低之间没有关联。这些发现应在足够有力的随机对照试验中得到证实。ClinicalTrials.gov标识符:NCT01947621。95%置信区间(CI)0.50-3.04,P = 0.64]或5年随访(HR 1.11,95%CI 0.78-1.58,P = 0.58)。这些结果通过使用基于PS的替代方法进行的敏感性分析得到了证实,即协变量调整和治疗加权的逆概率。结论在本研究中,在TTS患者中使用阿司匹林与30天和5年随访时MACCE风险降低之间没有关联。这些发现应在足够有力的随机对照试验中得到证实。ClinicalTrials.gov标识符:NCT01947621。95%置信区间(CI)0.50-3.04,P = 0.64]或5年随访(HR 1.11,95%CI 0.78-1.58,P = 0.58)。这些结果通过使用基于PS的替代方法(即协变量调整和治疗权重的倒数)进行的敏感性分析得到了证实。结论在本研究中,在TTS患者中使用阿司匹林与30天和5年随访时MACCE风险降低之间没有关联。这些发现应在足够有力的随机对照试验中得到证实。ClinicalTrials.gov标识符:NCT01947621。在30天和5年的随访中,在TTS患者中使用阿司匹林与降低MACCE的风险之间没有关联。这些发现应在足够有力的随机对照试验中得到证实。ClinicalTrials.gov标识符:NCT01947621。在TTS患者中使用阿司匹林与30天和5年随访时降低MACCE的风险之间没有关联。这些发现应在足够有力的随机对照试验中得到证实。ClinicalTrials.gov标识符:NCT01947621。
更新日期:2019-12-21
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