NCT06509074NOT YET RECRUITINGPhase 4The Beta-blockers in Takotsubo syndrome (TTS) (β-Tako) trial, is an academic, pragmatic, prospective, multicenter randomized clinical trial, aiming to assess the efficacy of beta-blockers (BB) in TTS patients. Two-hundred patients with TTS will be randomized (1:1) to BB (n=100) or no BB (n=100). BB with alpha or nitric oxide release activity will be used in the treatment arm. The primary endpoint will be the comparison of the wall motion score index by echocardiography at 7 days. A composite clinical endpoint (death, stroke, admission for recurrent TTS, ACS, heart failure or atrial fibrillation) at 1 year, will be assessed by an independent clinical events committee. Several sub-studies will be performed. The β-Tako trial will inform treatment decisions in this uniquely challenging clinical entity.
Inclusion Criteria: * Written informed consent. * Diagnosis of TTS with exclusion of significant coronary artery disease (CAD) by invasive coronary angiography Exclusion Criteria: * Patients diagnosed of TTS \> 48 hours before. * Persistent ccardiogenic shock or severe hemodynamic instability * Persistent severe (\>30 mmHg) intraventricular gradient * Previous diagnosis of severe valvular or ventricular disease or prior myocardial infarction secondary to atherosclerotic CAD * Patients already receiving treatment with betablockers (\*) * Absolute contraindication/indication for beta-blockers (\*\*) * Poor echocardiographic window * Pregnant or breastfeeding women. * Participation in another clinical trial. (\*) Betablockers at a therapeutic dose at the time of symptom´s onset. (\*\*) Close ECG monitoring required in patients with hypotension, bradycardia or cQT interval prolongation