Francesco Santoro1, Thomas Stiermaier2, Nicola Tarantino3, Francesca Guastafierro3, Tobias Graf2, Christian Möller2, Luigi F M Di Martino4, Holger Thiele2, Matteo Di Biase3, Ingo Eitel2, Natale Daniele Brunetti5. 1. University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy; Department of Cardiology, Asklepios Klinik - St Georg, Hamburg, Germany. 2. University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Lübeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany. 3. University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy. 4. Department of Cardiology, Santa Maria degli Angeli Hospital, Putignano, Italy. 5. University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy. Electronic address: natale.brunetti@unifg.it.
Abstract
BACKGROUND: Potential predictors of clinical complications of Takotsubo syndrome (TTS) are poorly known. Persistent ST-segment elevation (PSTE) may have an impact on outcome similar as previously reported in acute coronary syndrome. The aim of this study was to assess the prevalence and prognostic relevance of PSTE in patients with TTS. METHODS: Two-hundred-sixty-nine consecutive patients were enrolled in an international multicenter registry. PSTE was defined as the documentation of ST-elevation at least for the first 48h of hospitalization. Long-term mortality was evaluated in median 1.9years after the acute event. RESULTS: PSTE was found in 52 TTS patients (19%). Patients with PSTE were characterized by higher admission levels of troponin-I (23±12 vs 8±49ng/L, p<0.001), experienced a longer hospitalization (10±5 vs 8±3days, p=0.02) and a higher rate of in-hospital complications (31% vs 17% p=0.03). At multivariate analysis including PSTE, age, male sex, admission ejection fraction, PSTE (odds ratio [OR] 4.2; 95% confidence interval [CI] 1.4-13; p=0.01), age (OR 1.05; 95%CI 1.00-1.10; p=0.03) and admission ejection fraction (OR 0.93; 95%CI 0.87-0.99; p=0.02) were independent predictors of in-hospital complications. At long-term follow-up no significant differences in terms of mortality were observed between patients with and without PSTE (19% vs 15%; p=0.5). However, PSTE was a predictor of major cardiac adverse events (MACE) at follow-up (HR 2.32, 95% CI 1.02-5.31, p 0.045). CONCLUSIONS: In TTS patients, PSTE is a common finding, represents an independent predictor of in-hospital complications and could be associated with MACE at follow-up.
BACKGROUND: Potential predictors of clinical complications of Takotsubo syndrome (TTS) are poorly known. Persistent ST-segment elevation (PSTE) may have an impact on outcome similar as previously reported in acute coronary syndrome. The aim of this study was to assess the prevalence and prognostic relevance of PSTE in patients with TTS. METHODS: Two-hundred-sixty-nine consecutive patients were enrolled in an international multicenter registry. PSTE was defined as the documentation of ST-elevation at least for the first 48h of hospitalization. Long-term mortality was evaluated in median 1.9years after the acute event. RESULTS: PSTE was found in 52 TTS patients (19%). Patients with PSTE were characterized by higher admission levels of troponin-I (23±12 vs 8±49ng/L, p<0.001), experienced a longer hospitalization (10±5 vs 8±3days, p=0.02) and a higher rate of in-hospital complications (31% vs 17% p=0.03). At multivariate analysis including PSTE, age, male sex, admission ejection fraction, PSTE (odds ratio [OR] 4.2; 95% confidence interval [CI] 1.4-13; p=0.01), age (OR 1.05; 95%CI 1.00-1.10; p=0.03) and admission ejection fraction (OR 0.93; 95%CI 0.87-0.99; p=0.02) were independent predictors of in-hospital complications. At long-term follow-up no significant differences in terms of mortality were observed between patients with and without PSTE (19% vs 15%; p=0.5). However, PSTE was a predictor of major cardiac adverse events (MACE) at follow-up (HR 2.32, 95% CI 1.02-5.31, p 0.045). CONCLUSIONS: In TTS patients, PSTE is a common finding, represents an independent predictor of in-hospital complications and could be associated with MACE at follow-up.
Authors: Nicola Tarantino; Francesco Santoro; Francesca Guastafierro; Luigi F M Di Martino; Maria Scarcia; Riccardo Ieva; Antonio Ruggiero; Andrea Cuculo; Enrica Mariano; Matteo Di Biase; Natale Daniele Brunetti Journal: Ann Noninvasive Electrocardiol Date: 2018-07-09 Impact factor: 1.468
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
Authors: Sara Moscatelli; Fabrizio Montecucco; Federico Carbone; Alberto Valbusa; Laura Massobrio; Italo Porto; Claudio Brunelli; Gian Marco Rosa Journal: Biomed Res Int Date: 2019-10-30 Impact factor: 3.411