Title:Drugs as Possible Triggers of Takotsubo Cardiomyopathy- Update 2022: Systematic Review
Volume: 21
Issue: 5
Author(s): Valentina Lopera, Jaime Andrés Pereañez and Pedro Jose Amariles*
Affiliation:
- Grupo de Investigación, Promoción y Prevención Farmacéutica, Departamento de Farmacia, Facultad de Ciencias
Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, Colombia
Keywords:
Takotsubo cardiomyopathy, stress cardiomyopathy, drug-induced, iatrogenic, sympathomimetic drugs, sympathetic activation.
Abstract:
Background: A list of drugs that can induce takotsubo cardiomyopathy (TCM) was published
in 2011 and 2016. The aim of the present review was to update this list.
Methods: Similar to the 2011 and 2016 reviews, from April 2015 to May 2022 case reports of druginduced
TCM were identified by a comprehensive search in Medline/PubMed database. The search
terms were: takotsubo cardiomyopathy, tako-tsubo cardiomyopathy, stress cardiomyopathy, transientleft-
ventricular ballooning syndrome, apical ballooning syndrome, ampulla cardiomyopathy OR broken
heart syndrome; together with “iatrogenic”, “induced by” OR “drug-induced”. Registers published in
English or Spanish, in humans, and with full texts were retrieved. Articles that recognized any drug
associated with the development of TCM were selected.
Results: Overall, 184 manuscripts were identified by the search. A total of 39 articles were included
after an exhaustive revision. Eighteen drugs as possible triggers of TCM were identified in the current
update. Of them, 3 (16.7%) have been previously identified, and 15 (83.3%) are different from the previous
reports. Thus, the list of drugs as possible triggers of TCM updated in 2022 includes 72 drugs.
Conclusion: There are new case reports that link drugs with the development of TCM. The current list
is principally made up of drugs that generate sympathetic overstimulation. However, some of the listed
drugs do not have a clear link with sympathetic activation.