Victoria L Cammann1, Konrad A Szawan1, Barbara E Stähli1, Ken Kato1, Monika Budnik2, Manfred Wischnewsky3, Sara Dreiding1, Rena A Levinson1, Davide Di Vece1, Sebastiano Gili4, Rodolfo Citro5, Eduardo Bossone6, Michael Neuhaus7, Jennifer Franke8, Benjamin Meder8, Miłosz Jaguszewski9, Michel Noutsias10, Maike Knorr11, Susanne Heiner11, Fabrizio D'Ascenzo12, Wolfgang Dichtl13, Christof Burgdorf14, Behrouz Kherad15, Carsten Tschöpe15, Annahita Sarcon16, Jerold Shinbane17, Lawrence Rajan18, Guido Michels19, Roman Pfister19, Alessandro Cuneo20, Claudius Jacobshagen21, Mahir Karakas22, Wolfgang Koenig23, Alexander Pott24, Philippe Meyer25, Marco Roffi25, Adrian Banning26, Mathias Wolfrum27, Florim Cuculi28, Richard Kobza28, Thomas A Fischer29, Tuija Vasankari30, K E Juhani Airaksinen30, L Christian Napp31, Rafal Dworakowski32, Philip MacCarthy32, Christoph Kaiser33, Stefan Osswald33, Leonarda Galiuto34, Christina Chan35, Paul Bridgman35, Daniel Beug36, Clément Delmas37, Olivier Lairez37, Ekaterina Gilyarova38, Alexandra Shilova38, Mikhail Gilyarov38, Ibrahim El-Battrawy39, Ibrahim Akin39, Karolina Poledniková40, Petr Toušek40, David E Winchester41, Jan Galuszka42, Christian Ukena43, Gregor Poglajen44, Pedro Carrilho-Ferreira45, Christian Hauck46, Carla Paolini47, Claudio Bilato47, Yoshio Kobayashi48, Toshihiro Shoji49, Iwao Ishibashi49, Masayuki Takahara50, Toshiharu Himi50, Jehangir Din51, Ali Al-Shammari51, Abhiram Prasad52, Charanjit S Rihal52, Kan Liu53, P Christian Schulze54, Matteo Bianco55, Lucas Jörg56, Hans Rickli56, Gonçalo Pestana57, Thanh H Nguyen58, Michael Böhm43, Lars S Maier46, Fausto J Pinto45, Petr Widimský40, Stephan B Felix36, Ruediger C Braun-Dullaeus27, Wolfgang Rottbauer24, Gerd Hasenfuß21, Burkert M Pieske59, Heribert Schunkert60, Martin Borggrefe39, Holger Thiele61, Johann Bauersachs31, Hugo A Katus8, John D Horowitz58, Carlo Di Mario62, Thomas Münzel11, Filippo Crea34, Jeroen J Bax63, Thomas F Lüscher64, Frank Ruschitzka1, Jelena R Ghadri1, Grzegorz Opolski2, Christian Templin65. 1. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. 2. Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. 3. FB Mathematics and Computer Science, University of Bremen, Bremen, Germany. 4. Centro cardiologico Monzino, IRCCS, Milan, Italy. 5. Heart Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy. 6. Division of Cardiology, "Antonio Cardarelli" Hospital, Naples, Italy. 7. Department of Cardiology, Kantonsspital Frauenfeld, Frauenfeld, Switzerland. 8. Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany. 9. First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland. 10. Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany. 11. Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany. 12. Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy. 13. University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria. 14. Heart and Vascular Centre Bad Bevensen, Bad Bevensen, Germany. 15. Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany. 16. Section of Cardiac Electrophysiology, Department of Medicine, University of California-San Francisco, San Francisco, California. 17. University of Southern California, Keck School of Medicine, Los Angeles, California. 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, Stadtlohn, 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. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 24. Department of Internal Medicine II-Cardiology, University of Ulm, Medical Center, Ulm, Germany. 25. Service de cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 26. Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, United Kingdom. 27. Department of Internal Medicine, Cardiology and Angiology, Magdeburg University, Magdeburg, Germany. 28. Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland. 29. Department of Cardiology, Kantonsspital Winterthur, Winterthur, Switzerland. 30. Heart Center, Turku University Hospital and University of Turku, Turku, Finland. 31. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. 32. Department of Cardiology, King's College Hospital, London, United Kingdom. 33. Department of Cardiology, University Hospital Basel, Basel, Switzerland. 34. Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 35. Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand. 36. Department of Cardiology and Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany. 37. Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France. 38. Intensive Coronary Care Unit, Moscow City Hospital #1 named after N. Pirogov, Moscow, Russia. 39. 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. 40. Cardiocenter, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady, Prague, Czech Republic. 41. Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida. 42. Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic. 43. Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. 44. Advanced Heart Failure and Transplantation Center, University Medical Center Ljubljana, Ljubljana, Slovenia. 45. Santa Maria University Hospital, CHULN, Center of Cardiology of the University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical Center, Lisboa, Portugal. 46. Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany. 47. Local Health Unit n.8, Cardiology Unit, Arzignano, Vicenza, Italy. 48. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. 49. Department of Cardiology, Chiba Emergency Medical Center, Chiba, Japan. 50. Division of Cardiology, Kimitsu Central Hospital, Kisarazu, Japan. 51. Dorset Heart Centre, Royal Bournemouth Hospital, Bournemouth, United Kingdom. 52. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. 53. Division of Cardiology, Heart and Vascular Center, University of Iowa, Iowa City, Iowa. 54. Department of Internal Medicine I, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany. 55. Division of Cardiology, A.O.U San Luigi Gonzaga, Orbassano, Turin, Italy. 56. Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 57. Department of Cardiology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal. 58. Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia. 59. Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin Institute of Health (BIH), Berlin, Germany. 60. Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany; Local Health Unit n.8, Cardiology Unit, Arzignano, Vicenza, Italy. 61. Heart Center Leipzig - University Hospital, Department of Internal Medicine/Cardiology, Leipzig, Germany. 62. Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy. 63. Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands. 64. Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Zurich, Switzerland; Royal Brompton and Harefield Hospitals Trust and Imperial College, London, United Kingdom. 65. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. Electronic address: Christian.Templin@usz.ch.
Abstract
BACKGROUND: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. OBJECTIVES: This study aimed to investigate age-related differences in TTS. METHODS: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. RESULTS: Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. CONCLUSIONS: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.
BACKGROUND:Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. OBJECTIVES: This study aimed to investigate age-related differences in TTS. METHODS:Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. RESULTS: Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. CONCLUSIONS: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.
Authors: Seyyedmohammadsadeq Mirmoeeni; Amirhossein Azari Jafari; John V Lacci; Ali Seifi Journal: Neurocrit Care Date: 2022-09-22 Impact factor: 3.532
Authors: Trisha Singh; Hilal Khan; David T Gamble; Caroline Scally; David E Newby; Dana Dawson Journal: Circulation Date: 2022-03-28 Impact factor: 29.690
Authors: Boris K Kurbatov; Ekaterina S Prokudina; Leonid N Maslov; Natalia V Naryzhnaya; Sergey V Logvinov; Alexander S Gorbunov; Alexandr V Mukhomedzyanov; Andrey V Krylatov; Nikita S Voronkov; Andrey S Sementsov; Konstantin V Zavadovsky; Viktor V Saushkin; Rajendra P Nagarajan; Peter R Oeltgen Journal: Pflugers Arch Date: 2021-07-10 Impact factor: 3.657