Abstract 12829: Short- and Long-Term Outcomes of Takotsubo Syndrome and Acute Coronary Syndrome. A Meta-Analysis

Abstract

Introduction: Takotsubo syndrome (TTS) is a condition characterized by reversible left ventricular dysfunction with typical regional wall motion abnormalities. Although the presentation mimics acute coronary syndrome (ACS), its exact pathophysiology is not known. Despite the transient nature of cardiac dysfunction in TTS, the prognosis remained uncertain, with mortality rates reportedly comparable to that of ACS. The aim of this study was to compare the outcomes between patients with TS and ACS through a meta-analysis. Methods: We systematically searched various electronic databases including PubMed, Embase, and Cochrane Library to identify relevant studies. The outcomes were pooled using the Hartung-Knapp-Sidik-Jonkman random effects model, and the results were presented as odds ratio (OR) with their corresponding 95% confidence interval (CI). Results: 11 studies with 3,455,862 (95,165 TTS and 3,360,697 ACS) patients were included in the final analysis. The risk of in-hospital mortality (OR, 0.61(95%CI: 0.42-0.89), P=0.01), 30-day mortality (OR, 0.62(95%CI: 0.48-0.81), P<0.001) were significantly lower in the TTS group compared to the ACS group. There was no difference in the risk of cardiogenic shock (OR, 0.87(95%CI: 0.54-1.42), P=0.58) between both groups. The risk of long-term all-cause mortality (OR, 1.10(95%CI: 0.61-1.97), P=0.75) was comparable between both groups, with significantly higher non-cardiovascular cause of mortality (OR, 2.40(95%CI: 1.83-3.15), P<0.001) among the TTS group compared to the ACS group. Conclusions: This study suggests a favorable short-term prognosis for TTS patients compared to ACS patients, but a comparable risk of long-term mortality. It is noteworthy that TTS patients have a higher risk of non-cardiovascular mortality. Further studies are warranted to explore the factors contributing to the increased risk of non-cardiovascular mortality in TTS patients in order to improve outcomes in this population.