{
  "abstract": "Introduction Takotsubo cardiomyopathy (TC) is a stress-induced catecholamine acute myocardial dysfunction in the absence of significant coronary disease. The pathophysiology of TC remains poorly understood, and the use of beta-blockers (β-Blockers) appears promising. However, the impact of β-blockers in acute-phase management remains uncertain.Aims We aimed to conduct a systematic review and meta-analysis evaluating the early use of β-Blocker in TC and its effects on in-hospital mortality.Methods PubMed, Embase and Cochrane were searched for studies that evaluated the use of BBs in TC patients and its short-term effects. Statistical analysis was performed using RevMan V,5.4.1. The results are expressed using HRs and 95% confidence intervals (CI) were extracted using a random-effects model. Heterogeneity was assessed with I².Results We included five cohort studies, with a total of 5428 patients. The vast majority were women (81%) with a mean age of 70.1±12.6 years. More than half of the patients (52.0%) had previous hypertension. ST-elevation in the first ECG was observed in 37.3% of the patients. Early administration of β-blockers was not associated with a statistically significant reduction in in-hospital mortality (HR 0.78, 95% CI 0.59 to 1.02, p=0.07), and this finding was consistent across different β-blocker types, doses and routes of administration.Conclusion Early β-Blocker therapy did not significantly influence in-hospital mortality in patients with TC. Future randomised studies are essential to clarify beta-blockers’ role in this setting.PROSPERO registration number CRD420251055617.",
  "authors": [
    {
      "affiliations": [
        "Medical Sciences Research Center, University Center for the Development of Alto Vale, Brazil, UNIDAVI, Rio do Sul, Brazil"
      ],
      "name": "Caroline de Oliveira Fischer Bacca"
    },
    {
      "affiliations": [
        "Albert Einstein Instituto Israelito de Ensino e Pesquisa, São Paulo, SP, Brazil"
      ],
      "name": "Beatriz Stephan"
    },
    {
      "affiliations": [
        "Hospital Auxilio Mutuo San Pablo, Bayamón, Puerto Rico"
      ],
      "name": "Victor Alejandro Gomez"
    },
    {
      "affiliations": [
        "Medical Sciences Research Center, University Center for the Development of Alto Vale, Brazil, UNIDAVI, Rio do Sul, Brazil"
      ],
      "name": "Marcelo Vier Gambetta"
    },
    {
      "affiliations": [
        "Albert Einstein Instituto Israelito de Ensino e Pesquisa, São Paulo, SP, Brazil"
      ],
      "name": "Giovanna Cardoso de Moraes"
    },
    {
      "affiliations": [
        "Albert Einstein Israelite Hospital, Sao Paulo, Brazil"
      ],
      "name": "Giulia Lisanti Soares"
    },
    {
      "affiliations": [
        "Faculdades Integradas Pitágoras de Montes Claros, Montes Claros, MG, Brazil"
      ],
      "name": "Marina Machado"
    },
    {
      "affiliations": [
        "University of Debrecen Faculty of Medicine, Debrecen, Hungary"
      ],
      "name": "Vinh Quang Tri Ho"
    },
    {
      "affiliations": [
        "Cardiology and Intensive Care, Albert Einstein Israelite Hospital, Sao Paulo, Brazil"
      ],
      "name": "Luciana Gioli-Pereira"
    }
  ],
  "title": "Use of beta-blockers and in-hospital mortality in patients with Takotsubo cardiomyopathy: systematic review and meta-analysis",
  "uid": "aa8850a1-0405-5a6a-977b-da22c43d9bd4"
}