Edita Pogran1,2, Ahmed Abd El-Razek3, Laura Gargiulo3, Valerie Weihs4, Christoph Kaufmann4,5, Samuel Horváth6, Alexander Geppert4,5, Michael Nürnberg4,5, Emil Wessely4,5, Peter Smetana4,5, Kurt Huber4,5,3. 1. 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, Montleartstraße 37, 1160, Vienna, Austria. edita.pogran@gmail.com. 2. Ludwig Boltzmann Institute for Interventional Cardiology and Rhythmology, Währinger Gürtel 18-20, 1090, Vienna, Austria. edita.pogran@gmail.com. 3. Medical School, Sigmund Freud Private University, Freudplatz 1, 1020, Vienna, Austria. 4. 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, Montleartstraße 37, 1160, Vienna, Austria. 5. Ludwig Boltzmann Institute for Interventional Cardiology and Rhythmology, Währinger Gürtel 18-20, 1090, Vienna, Austria. 6. King Abdullah University of Science and Technology, 23955, Thuwal, Saudi Arabia.
Abstract
BACKGROUND: There is an increasing amount of evidence suggesting multiple fatal complications in takotsubo syndrome; however, findings on the long-term outcome are scarce and show inconsistent evidence. METHODS: This is a single center study of long-term prognosis in takotsubo patients admitted to the Klinik Ottakring, Vienna, Austria, from September 2006 to August 2019. We investigated the clinical features, prognostic factors and outcome of patients with takotsubo syndrome. Furthermore, survivors and non-survivors and patients with a different cause of death were compared. RESULTS: Overall, 147 patients were included in the study and 49 takotsubo patients (33.3%) died during the follow-up, with a median of 126 months. The most common cause of death was a non-cardiac cause (71.4% of all deaths), especially malignancies (26.5% of all deaths). Moreover, non-survivors were older and more often men with more comorbidities (chronic kidney disease, malignancy). Patients who died because of cardiovascular disease were older and more often women than patients who died due to non-cardiovascular cause. Adjusted analysis showed no feature of an independent predictor of cardiovascular mortality for takotsubo patients. Female gender (HR = 0.32, CI: 0.16-0.64, p < 0.001), cancer (HR = 2.35, CI: 1.15-4.8, p = 0.019) and chronic kidney disease (HR = 2.61, CI: 1.11-6.14, p = 0.028) showed to be independent predictors of non-cardiovascular mortality. CONCLUSION: Long-term prognosis of takotsubo patients is not favorable, mainly due to noncardiac comorbidities. Hence, consequent outpatient care in regular intervals after a takotsubo event based on risk factor control and early detection of malignancies seems justified.
BACKGROUND: There is an increasing amount of evidence suggesting multiple fatal complications in takotsubo syndrome; however, findings on the long-term outcome are scarce and show inconsistent evidence. METHODS: This is a single center study of long-term prognosis in takotsubo patients admitted to the Klinik Ottakring, Vienna, Austria, from September 2006 to August 2019. We investigated the clinical features, prognostic factors and outcome of patients with takotsubo syndrome. Furthermore, survivors and non-survivors and patients with a different cause of death were compared. RESULTS: Overall, 147 patients were included in the study and 49 takotsubo patients (33.3%) died during the follow-up, with a median of 126 months. The most common cause of death was a non-cardiac cause (71.4% of all deaths), especially malignancies (26.5% of all deaths). Moreover, non-survivors were older and more often men with more comorbidities (chronic kidney disease, malignancy). Patients who died because of cardiovascular disease were older and more often women than patients who died due to non-cardiovascular cause. Adjusted analysis showed no feature of an independent predictor of cardiovascular mortality for takotsubo patients. Female gender (HR = 0.32, CI: 0.16-0.64, p < 0.001), cancer (HR = 2.35, CI: 1.15-4.8, p = 0.019) and chronic kidney disease (HR = 2.61, CI: 1.11-6.14, p = 0.028) showed to be independent predictors of non-cardiovascular mortality. CONCLUSION: Long-term prognosis of takotsubo patients is not favorable, mainly due to noncardiac comorbidities. Hence, consequent outpatient care in regular intervals after a takotsubo event based on risk factor control and early detection of malignancies seems justified.
Authors: David Zweiker; Edita Pogran; Laura Gargiulo; Ahmed Abd El-Razek; Ivan Lechner; Ivan Vosko; Stefan Rechberger; Heiko Bugger; Günter Christ; Diana Bonderman; Evelyn Kunschitz; Clara Czedik-Eysenberg; Antonia Roithinger; Valerie Weihs; Christoph C Kaufmann; Andreas Zirlik; Axel Bauer; Bernhard Metzler; Thomas Lambert; Clemens Steinwender; Kurt Huber Journal: Biology (Basel) Date: 2022-08-01