The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Traditional Chinese Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
BMJ Open. 2021 Aug 10;11(8):e046727. doi: 10.1136/bmjopen-2020-046727.
Takotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management.
After searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible.
Ethics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal.
CRD42020212729.
应激性心肌病（TTS）是一种由严重应激引起的左心室功能突然可逆性减弱的疾病，其特征类似于急性冠状动脉综合征。尽管已经发布了许多关于 TTS 的指南，但对于长期治疗仍未达成共识。阿司匹林是出院时为患者开具的最常见药物之一，目的是减少血栓事件并改善整体预后。然而，现有研究对其疗效的结果存在争议。本研究旨在评估 TTS 患者长期应用阿司匹林维持治疗的影响，并为临床管理提供参考。
通过检索电子数据库（PubMed、Embase、Cochrane 图书馆、Web of Science、美国国家医学图书馆网关、CNKI、万方和 VIP）、灰色文献、会议摘要和临床试验注册中心，寻找关于阿司匹林对 TTS 患者影响的临床研究，进行系统评价和荟萃分析。检索将从每个数据库的开始时间限制到 2020 年 8 月 1 日。将在 30 天和 5 年随访时评估全因死亡、TTS 复发、卒中和短暂性脑缺血发作或心肌梗死等结局。使用纽卡斯尔-渥太华质量评估量表对观察性研究和 Cochrane 有效实践和组织护理评价工具对干预性研究进行偏倚风险评估。将应用推荐评估、制定和评估方法对证据质量进行分级。如果有，将使用随机效应模型和 95%CI 下的相对风险评估阿司匹林对 TTS 患者上述结局的影响。如果可能，还将进行亚组分析和敏感性分析。
由于研究的回顾性性质，不需要伦理批准。审查结果将发表在同行评议的期刊上。
PROSPERO 注册号：CRD42020212729。
