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Response to: Correspondence on ‘Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome’ by John E Madias
  1. Rodolfo Citro1,2,
  2. Angelo Silverio3,
  3. Michele Bellino3,
  4. Guido Parodi4,
  5. Eduardo Bossone5
  1. 1 Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
  2. 2 Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli, Italy
  3. 3 Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
  4. 4 Department of Cardiology, ASL4 Liguria, Lavagna, Italy
  5. 5 Division of Cardiology, Antonio Cardarelli Hospital, Naples, Italy
  1. Correspondence to Dr Rodolfo Citro, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno 84131, Italy; rodolfocitro{at}

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The Authors’ reply

We thank Dr Madias for his interest in our study and for the opportunity to further discuss the long-term effects of beta-blockers in patients with takotsubo syndrome (TTS).1

The association between TTS outcome and beta-blockers use is complex and multifactorial. In our registry, beta-blocker prescription at discharge was associated with the reduction of all-cause mortality, but not of TTS recurrence. One could interpret this result as the confirmation that beta-blockers do not have a significant effect in terms of preventing TTS recurrence, which is consistent with previous observational studies.2 ,3 Although we find a lower incidence of TTS recurrence between patients treated and non-treated with beta-blockers, we cannot exclude that our results were not statistically significant …

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  • Contributors All authors contributed equally to this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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