Abstract 4366712: Long term outcomes of Beta blocker use in Takotsubo Syndrome- A Propensity Matched Analysis

Background: Beta blockers are often used in patients with Takotsubo syndrome to reduce sympathetic nervous system activation, but their long-term effects on outcomes are not well defined. This study aims to evaluate the long-term outcomes associated with beta blocker initiation in Takotsubo syndrome using a large, real-world patient cohort Methods: A retrospective cohort study was conducted using the TriNetX network. Adult patients with diagnosis of Takotsubo syndrome were identified using relevant ICD-10 CM codes and categorized into two groups based on beta blocker initiation within one month of Takotsubo syndrome diagnosis. Propensity score matching (1:1) was used to balance baseline demographics and comorbidities. The primary outcome was 5-year mortality. Secondary outcomes included myocardial infarction (MI), heart failure, arrhythmias, cardiac arrest, heart failure and all-cause hospitalization. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. A two-tailed p less than 0.05 was considered statistically significant Results: After matching, N= 8,132 patients in each cohort were analyzed. At 5 year follow up, Beta blocker cohort had decreased all cause hospitalizations (OR 0.817, 95%CI 0.707-0.944) but no statistical significant differences in all cause mortality (OR 0.932, 95% CI 0.862-1.008), MI (OR 1.044, 95% CI 0.911-1.196), cardiac arrest (OR 1.082, 95% CI 0.850-1.376), Afib (OR 0.882, 95% CI 0.776-1.002). Further, Beta blocker cohort had a statistically significant increase in new Heart Failure (OR 1.142, 95% CI 1.037-1.257). Conclusion: Beta blocker use was associated with a significant reduction in all-cause hospitalizations but an increased risk of new heart failure and no significant mortality benefits over five years. These findings highlight the need for further prospective data to establish clear guidelines for beta blocker use in Takotsubo syndrome.