Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy
Background Serotonin–norepinephrine reuptake inhibitors (SNRIs) inhibit the presynaptic reuptake of serotonin and norepinephrine and are widely used in the treatment of depression and neuropathic pain. We evaluate the impact of SNRIs use on the clinical outcomes of patients presenting with Takotsubo...
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| Format: | Article |
| Language: | English |
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Wiley
2025-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037951 |
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| author | Garba Rimamskep Shamaki Anderson Anuforo Israel Safiriyu David Corteville Monika Sanghavi Samit Shah Katherine Clark |
| author_facet | Garba Rimamskep Shamaki Anderson Anuforo Israel Safiriyu David Corteville Monika Sanghavi Samit Shah Katherine Clark |
| author_sort | Garba Rimamskep Shamaki |
| collection | DOAJ |
| description | Background Serotonin–norepinephrine reuptake inhibitors (SNRIs) inhibit the presynaptic reuptake of serotonin and norepinephrine and are widely used in the treatment of depression and neuropathic pain. We evaluate the impact of SNRIs use on the clinical outcomes of patients presenting with Takotsubo cardiomyopathy (TCM). Methods We analyzed data from the TriNetX research network. Patients aged ≥18 years with a principal diagnosis of TCM were identified from January 1, 2003, to December 31, 2023. After excluding patients on SSRIs, stimulants, 5‐fluorouracil, capecitabine, gemcitabine, and trastuzumab, patients with myocarditis, pheochromocytoma, acute myocardial infarction, cocaine‐related disorders, and opioid‐related disorders, were also excluded. The final study population was divided into 2 cohorts: patients on SNRIs and patients not on SNRIs. Propensity score matching was used to adjust for potential confounders. The primary outcome was all‐cause mortality, and the secondary outcome was Takotsubo cardiomyopathy‐related complications. Results A total of 16 853 patients with a diagnosis of TCM were identified, of which 2482 (14.7%) were on SNRIs. The SNRIs cohort were older (mean age 64.1 versus 63.4 years, P=0.012). After propensity score matching, patients on SNRI had lower 7‐day mortality (odds ratio [OR], 0.59 [95% CI, 0.41–0.84], P=0.004), cardiac arrest (OR, 0.58 [95% CI, 0.40–0.84], P=0.004), and ventricular fibrillation (OR, 0.496 [95% CI, 0.248–0.995], P=0.044). At 1 year, patients on SNRI had lower mortality (OR, 0.80 [95% CI, 0.67–0.96], P=0.015). Conclusions The use of SNRIs among patients presenting with TCM is associated with lower mortality and lower TCM‐related complications. |
| format | Article |
| id | doaj-art-3523bf85b974433fb9cea33381fc0b6d |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-3523bf85b974433fb9cea33381fc0b6d2025-08-20T03:34:45ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141310.1161/JAHA.124.037951Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo CardiomyopathyGarba Rimamskep Shamaki0Anderson Anuforo1Israel Safiriyu2David Corteville3Monika Sanghavi4Samit Shah5Katherine Clark6Department of Medicine Tower Health Reading Hospital West Reading PA USADepartment of Cardiovascular Diseases Suny Upstate Medical University Syracuse NY USADepartment of Cardiovascular Diseases Yale School of Medicine New Haven CT USADepartment of Cardiovascular Diseases Rochester Regional Health/Unity Hospital Rochester PA USADepartment of Cardiovascular Diseases University of Pennsylvania Philadelphia PA USAInterventional Cardiology Department, Cardiovascular Disease Division Yale School of Medicine New Haven CT USAAdvanced Heart Failure Department, Cardiovascular Medicine Division Yale School of Medicine New Haven CT USABackground Serotonin–norepinephrine reuptake inhibitors (SNRIs) inhibit the presynaptic reuptake of serotonin and norepinephrine and are widely used in the treatment of depression and neuropathic pain. We evaluate the impact of SNRIs use on the clinical outcomes of patients presenting with Takotsubo cardiomyopathy (TCM). Methods We analyzed data from the TriNetX research network. Patients aged ≥18 years with a principal diagnosis of TCM were identified from January 1, 2003, to December 31, 2023. After excluding patients on SSRIs, stimulants, 5‐fluorouracil, capecitabine, gemcitabine, and trastuzumab, patients with myocarditis, pheochromocytoma, acute myocardial infarction, cocaine‐related disorders, and opioid‐related disorders, were also excluded. The final study population was divided into 2 cohorts: patients on SNRIs and patients not on SNRIs. Propensity score matching was used to adjust for potential confounders. The primary outcome was all‐cause mortality, and the secondary outcome was Takotsubo cardiomyopathy‐related complications. Results A total of 16 853 patients with a diagnosis of TCM were identified, of which 2482 (14.7%) were on SNRIs. The SNRIs cohort were older (mean age 64.1 versus 63.4 years, P=0.012). After propensity score matching, patients on SNRI had lower 7‐day mortality (odds ratio [OR], 0.59 [95% CI, 0.41–0.84], P=0.004), cardiac arrest (OR, 0.58 [95% CI, 0.40–0.84], P=0.004), and ventricular fibrillation (OR, 0.496 [95% CI, 0.248–0.995], P=0.044). At 1 year, patients on SNRI had lower mortality (OR, 0.80 [95% CI, 0.67–0.96], P=0.015). Conclusions The use of SNRIs among patients presenting with TCM is associated with lower mortality and lower TCM‐related complications.https://www.ahajournals.org/doi/10.1161/JAHA.124.037951antidepressantscardiomyopathydepressionmortalityserotonin–norepinephrine reuptake inhibitors (SNRIs)Takotsubo cardiomyopathy |
| spellingShingle | Garba Rimamskep Shamaki Anderson Anuforo Israel Safiriyu David Corteville Monika Sanghavi Samit Shah Katherine Clark Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease antidepressants cardiomyopathy depression mortality serotonin–norepinephrine reuptake inhibitors (SNRIs) Takotsubo cardiomyopathy |
| title | Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy |
| title_full | Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy |
| title_fullStr | Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy |
| title_full_unstemmed | Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy |
| title_short | Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy |
| title_sort | serotonin norepinephrine reuptake inhibitor is associated with lower mortality among patients presenting with takotsubo cardiomyopathy |
| topic | antidepressants cardiomyopathy depression mortality serotonin–norepinephrine reuptake inhibitors (SNRIs) Takotsubo cardiomyopathy |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037951 |
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