Is takotsubo syndrome a microvascular acute coronary syndrome? Towards of a new definition

Impact of aspirin on takotsubo syndrome: a propensity score‐based analysis of the InterTAK Registry

“…The protective effect of aspirin in acute cardiovascular diseases, however, is mainly related to the reduction of thrombotic events induced by platelet activation following plaque erosion or rupture. These mechanisms do not appear to play a significant role in TTS, as it appears that TTS mainly involves the microcirculatory system, thus this explains the lack of potential benefit associated with aspirin in this syndrome …”

“…These mechanisms do not appear to play a significant role in TTS, as it appears that TTS mainly involves the microcirculatory system, thus this explains the lack of potential benefit associated with aspirin in this syndrome. 36 Aspirin acts both as an antithrombotic as well as an antiinflammatory agent, suppressing the production of prostaglandins, thromboxane, and decreasing plasma levels of several inflammatory biomarkers, posing a potential prognostic benefit in TTS. Nevertheless, a negative interaction has been shown between aspirin (related to dose) and survival benefit of ACE inhibitor therapy in patients admitted for heart failure and could have implications in TTS patients as well.…”

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

“…31 There is also much evidence supporting the hypothesis that a brief period of ischemia due to microvascular dysfunction, perhaps mediated by the sympathetic/catecholamine storm, plays a role in the myocardial injury encountered in TTCM. 32,33 Other factors that may contribute to the pathophysiology of TTCM include disturbances of calcium homeostasis, estrogen, the emotional state of the patient, depression, the use of antidepressants, and preexisting endothelial dysfunction. 29 It has long been suspected that genetic factors, including certain polymorphisms of alpha-and beta-adrenergic receptors, may explain the susceptibility of certain individuals to stress cardiomyopathy, but conclusive findings are currently lacking.…”

The year in cardiology 2016: Acute coronary syndromes

“…This seems to be the case, in particular for takotsubo cardiomyopathy (TTC) 43 ( Figure 6). To this regards, one study illustrated that TTC can be triggered by not only negative but also positive life events.…”