BACKGROUND: Takotsubo cardiomyopathy (TC) is a myopathy triggered by severe stressful events. However, little is known about the determinants of in-hospital outcomes. We prospectively determined the effect of different triggers on the prognosis of TC. METHODS AND RESULTS: We enrolled patients who were admitted for suspected acute coronary syndrome (ACS) from January 2008 to December 2015. TC was diagnosed according to the Mayo Clinic diagnosis criteria. The outcome was in-hospital death. Among 1861 consecutive patients with suspected ACS, 82 (4.4%) patients were diagnosed with TC. There were 43 patients (52%) with physical triggers (Physical), 26 (31%) with emotional triggers, and 13 (17%) with no identifiable triggers. The latter two groups were combined and categorized as the Non-physical trigger group. Compared with non-physical triggered TC, patients with physical triggered TC were more likely to have a malignancy (p=0.008), lower blood pressure (p=0.001), lower hemoglobin (p<0.001), higher serum creatinine (p<0.001) and higher norepinephrine levels (p=0.007). During a mean hospital stay of 16±12days, 9 (20.9%) of the Physical and 1 (2.6%) of the Non-physical patients died in-hospital (log-rank p=0.007). After adjusting for the age, gender, trigger, malignancy, and hemoglobin level, being male (hazard ratio 11.9, 95% confidence interval, 2.43-58.5, p=0.002) and having a physical trigger (14.7, 1.19-166, p=0.03) were associated with in-hospital mortality. CONCLUSION: There was a significant difference in in-hospital mortality depending on the trigger type in TC. Being male and having a physical trigger were independent risk factors of in-hospital mortality from TC.
BACKGROUND:Takotsubo cardiomyopathy (TC) is a myopathy triggered by severe stressful events. However, little is known about the determinants of in-hospital outcomes. We prospectively determined the effect of different triggers on the prognosis of TC. METHODS AND RESULTS: We enrolled patients who were admitted for suspected acute coronary syndrome (ACS) from January 2008 to December 2015. TC was diagnosed according to the Mayo Clinic diagnosis criteria. The outcome was in-hospital death. Among 1861 consecutive patients with suspected ACS, 82 (4.4%) patients were diagnosed with TC. There were 43 patients (52%) with physical triggers (Physical), 26 (31%) with emotional triggers, and 13 (17%) with no identifiable triggers. The latter two groups were combined and categorized as the Non-physical trigger group. Compared with non-physical triggered TC, patients with physical triggered TC were more likely to have a malignancy (p=0.008), lower blood pressure (p=0.001), lower hemoglobin (p<0.001), higher serum creatinine (p<0.001) and higher norepinephrine levels (p=0.007). During a mean hospital stay of 16±12days, 9 (20.9%) of the Physical and 1 (2.6%) of the Non-physical patients died in-hospital (log-rank p=0.007). After adjusting for the age, gender, trigger, malignancy, and hemoglobin level, being male (hazard ratio 11.9, 95% confidence interval, 2.43-58.5, p=0.002) and having a physical trigger (14.7, 1.19-166, p=0.03) were associated with in-hospital mortality. CONCLUSION: There was a significant difference in in-hospital mortality depending on the trigger type in TC. Being male and having a physical trigger were independent risk factors of in-hospital mortality from TC.
Authors: Nasreen Shaikh; Muhammad Sardar; Aasems Jacob; Sayee Sundar Alagusundaramoorthy; Margaret Eng; John Checton; Ajay Shah Journal: Intractable Rare Dis Res Date: 2018-05
Authors: Sören J Backhaus; Thomas Stiermaier; Torben Lange; Amedeo Chiribiri; Pablo Lamata; Johannes Uhlig; Johannes T Kowallick; Uwe Raaz; Adriana Villa; Joachim Lotz; Gerd Hasenfuß; Holger Thiele; Ingo Eitel; Andreas Schuster Journal: Int J Cardiol Date: 2018-04-22 Impact factor: 4.164
Authors: Arash Nayeri; Eric Rafla-Yuan; Eric Farber-Eger; Marcia Blair; Boback Ziaeian; Martin Cadeiras; John A McPherson; Quinn S Wells Journal: Psychosomatics Date: 2017-10-18 Impact factor: 2.386
Authors: Ekaterina S Prokudina; Boris K Kurbatov; Konstantin V Zavadovsky; Alexander V Vrublevsky; Natalia V Naryzhnaya; Yuri B Lishmanov; Leonid N Maslov; Peter R Oeltgen Journal: Curr Cardiol Rev Date: 2021