Jelena R Ghadri1, Ken Kato1, Victoria L Cammann1, Sebastiano Gili2, Stjepan Jurisic1, Davide Di Vece1, Alessandro Candreva1, Katharina J Ding1, Jozef Micek1, Konrad A Szawan1, Beatrice Bacchi1, Rahel Bianchi1, Rena A Levinson3, Manfred Wischnewsky4, Burkhardt Seifert5, Susanne A Schlossbauer1, Rodolfo Citro6, Eduardo Bossone6, Thomas Münzel7, Maike Knorr7, Susanne Heiner7, Fabrizio D'Ascenzo8, Jennifer Franke9, Annahita Sarcon10, L Christian Napp11, Milosz Jaguszewski12, Michel Noutsias13, Hugo A Katus9, Christof Burgdorf14, Heribert Schunkert15, Holger Thiele16, Johann Bauersachs11, Carsten Tschöpe17, Burkert M Pieske17, Lawrence Rajan18, Guido Michels19, Roman Pfister19, Alessandro Cuneo20, Claudius Jacobshagen21, Gerd Hasenfuß21, Mahir Karakas22, Wolfgang Koenig15, Wolfgang Rottbauer23, Samir M Said24, Ruediger C Braun-Dullaeus24, Adrian Banning25, Florim Cuculi26, Richard Kobza26, Thomas A Fischer27, Tuija Vasankari28, K E Juhani Airaksinen28, Grzegorz Opolski29, Rafal Dworakowski30, Philip MacCarthy30, Christoph Kaiser31, Stefan Osswald31, Leonarda Galiuto32, Filippo Crea32, Wolfgang Dichtl33, Klaus Empen34, Stephan B Felix34, Clément Delmas35, Olivier Lairez35, Ibrahim El-Battrawy36, Ibrahim Akin36, Martin Borggrefe36, John Horowitz37, Martin Kozel38, Petr Tousek38, Petr Widimský38, Ekaterina Gilyarova39, Alexandra Shilova39, Mikhail Gilyarov39, David E Winchester40, Christian Ukena41, Jeroen J Bax42, Abhiram Prasad43, Michael Böhm41, Thomas F Lüscher44, Frank Ruschitzka1, Christian Templin45. 1. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. 2. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland; Division of Cardiology, Department of Medical Sciences, AOU Citta della Salute e della Scienza, University of Turin, Turin, Italy. 3. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland; Division of Biological Sciences, University of California, San Diego, La Jolla, California. 4. Department of Mathematics and Computer Science, University of Bremen, Bremen, Germany. 5. Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland. 6. Heart Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy. 7. Cardiology 1, Center for Cardiology, University Medical Center Mainz, Mainz, Germany. 8. Division of Cardiology, Department of Medical Sciences, AOU Citta della Salute e della Scienza, University of Turin, Turin, Italy. 9. Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany. 10. University of Southern California, Keck School of Medicine, Los Angeles, California. 11. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. 12. First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland. 13. Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Halle (Saale), Germany. 14. Heart and Vascular Centre Bad Bevensen, Bad Bevensen, Germany. 15. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 16. Heart Center Leipzig, University Hospital, Department of Internal Medicine/Cardiology, Leipzig, Germany. 17. Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany. 18. TJ Health Partners Heart and Vascular, Glasgow, Kentucky. 19. Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany. 20. Krankenhaus "Maria Hilf" Medizinische Klinik, Stadtlohne, Germany. 21. Clinic for Cardiology and Pneumology, Georg August University Goettingen, Goettingen, Germany. 22. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany; DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany. 23. Department of Internal Medicine II-Cardiology, University of Ulm, Medical Center, Ulm, Germany. 24. Internal Medicine/Cardiology, Angiology, and Pneumology, Magdeburg University, Magdeburg, Germany. 25. Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, United Kingdom. 26. Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland. 27. Department of Cardiology, Kantonsspital Winterthur, Winterthur, Switzerland. 28. Heart Center, Turku University Hospital and University of Turku, Turku, Finland. 29. Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. 30. Department of Cardiology, Kings College Hospital, Kings Health Partners, London, United Kingdom. 31. Department of Cardiology, University Hospital Basel, Basel, Switzerland. 32. Department of Cardiovascular Sciences, Catholic University of the Sacred Heart Rome, Rome, Italy. 33. University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria. 34. University Medicine Greifswald, Department of Internal Medicine B, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany. 35. Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France. 36. First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM) University of Heidelberg, Mannheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany. 37. Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia. 38. Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic. 39. Intensive Coronary Care Unit, Moscow City Hospital #1 named after N. Pirogov, Moscow, Russia. 40. Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida. 41. Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. 42. Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands. 43. Division of Cardiovascular Diseases Mayo Clinic, Rochester, Minnesota. 44. Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Switzerland; Royal Brompton and Harefield Hospitals Trust and Imperial College, London, United Kingdom. 45. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. Electronic address: christian.templin@usz.ch.
Abstract
BACKGROUND: Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive. OBJECTIVES: This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers. METHODS: Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions. RESULTS: Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients. CONCLUSIONS: Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621).
BACKGROUND: Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive. OBJECTIVES: This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers. METHODS:Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions. RESULTS: Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients. CONCLUSIONS: Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621).
Authors: Benjamin B Kenigsberg; Christopher F Barnett; Jeffrey C Mai; Jason J Chang Journal: Curr Neurol Neurosci Rep Date: 2019-11-13 Impact factor: 5.081
Authors: Krishna Ravindra; Marco G Del Buono; Juan G Chiabrando; Peter Westman; Edoardo Bressi; Dinesh Kadariya; Curtis Maehara; Megan Dell; Liangsuo Ma; Jessie VAN Wezenbeek; F Gerard Moeller; Lori Keyser-Marcus; Larry D Keen; Tamas S Gal; Antonio Abbate Journal: Minerva Cardiol Angiol Date: 2021-01-11
Authors: Muhammad Ali; Angelos G Rigopoulos; Khaldoun Ali; Ignatios Ikonomidis; George Makavos; Marios Matiakis; Hannes Melnyk; Elena Abate; Mammad Mammadov; Jan Lukas Prüser; Renato de Vecchis; Walter Wohlgemuth; Athanassios Manginas; Boris Bigalke; Sophie Mavrogeni; Daniel Sedding; Michel Noutsias Journal: Heart Fail Rev Date: 2020-09 Impact factor: 4.214