080 Prospective assessment of incidence of Tako-Tsubo cardiomyopathy

Abstract

Tako-Tsubo cardiomyopathy (TTC) is characterized by transient left ventricular (LV) dysfunction. Incidence of TTC has only been estimated by retrospective studies. In a previous retrospective study, we found that TTC prevalence was 0.7% of ACS. The aim of this study was to prospectively assess TTC incidence. We performed a multicentric prospective study. All consecutive patients referred for coronary angiography were included in three catheterization laboratories. The institutional review board approved the study protocol, and each patient provided written informed consent. Patients were classified as having (or not) coronary artery stenosis defined as a lesion of at least 50% diameter narrowing. In all patients without significant coronary artery stenosis, a right and left anterior oblique left ventricular angiogram was systematically performed. All these left ventricular angiograms were anonymously randomized and were systematically reviewed by three experts. Finally, we used the CARDIO-ARIF (Agence Régionale d’Hospitalisation d’Ile-de-France) registry, for the assessment of TTC incidence in Ile-de-France. The study population consisted of 2973 patients (women: 30.6%). Mean age was 63.3 years. An acute coronary syndrome (ACS) was diagnosed in 33.2% of these patients referred for coronary angiography. Twenty TTC were diagnosed (19 women, mean age: 63 years (55–73)). Incidence of TTC was 2% of ACS and 6.6% of ACS in women. Each year, in Ile-de-France, the number of TTC is estimated at 344 cases (95% CI = 216–514) and at 29.7 per 1,000,000 inhabitants (95% CI = 18.7–44.4). Our prospective study suggests that incidence of TTC is higher than incidence estimated by retrospective studies. Each year, 29.7 new cases of TTC per 1,000,000 inhabitants occur in Ile-de-France.