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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. 1Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
  2. 2Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli, Italy
  3. 3Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
  4. 4Department of Cardiology, ASL4 Liguria, Lavagna, Italy
  5. 5Division 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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