Abstract
Background Takotsubo syndrome (TTS) is characterized by acute transient, stress-induced, left ventricular systolic dysfunction, generally presenting with apical ballooning. It can mimic an acute coronary syndrome, but with a milder increase in cardiac enzymes and without culprit coronary artery disease on angiography. Data on long-term follow-up and survival in patients with TTS, compared with patients with ST-elevation myocardial infarction (STEMI), are scarce. Purpose To assess all-cause mortality rate and survival in a consecutive series of female patients with TTS compared with age- and sex-matched STEMI patients on long-term follow-up. Methods and Results We collected data of 65 TTS female patients (TTS group) with a mean age of 73.42 ± 11.35 years from 2001 to 2013. Collection of follow-up information was concluded for all patients in 2016. To compare the mortality and survival of TTS patients with those of the STEMI population, we used data from our STEMI Registry, a prospective registry of 7446 STEMI patients admitted from 2001 to 2013 to our cath-lab for primary percutaneous coronary intervention (p-PCI). From the registry, we selected 104 STEMI patients (STEMI group) comparable to our TTS group in terms of age (mean age of 72.33 ± 11.92 years) and sex. On follow-up examination after a median of 1000 days, the TTS group had a lower all-cause mortality rate than the STEMI group (7.69% versus 23.08%). This difference was statistically different between the two groups (log-rank test, p value = 0.03). Conclusions In our study, TTS and STEMI patients displayed a statistically significant difference in long-term survival. Specifically, the TTS group had a lower mortality rate than the STEMI group. This seems to suggest that TTS and STEMI are two different clinical entities with two different clinical outcomes.
Highlights
Takotsubo syndrome (TTS) is an acute and reversible cardiac condition characterized by transient left ventricular dysfunction [1]. is syndrome is distinct from acute myocardial infarction (AMI), the initial presentation has similar features to ST-segment elevatiton myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI)
Information concerning the long-term follow-up of patients with TTS is controversial: once believed to be a more benign condition compared with AMI [6], in recent studies, TTS appears to be burdened by significant mortality and morbidity [7, 8]
Our purpose was to assess rates of all-cause mortality and survival in a series of female patients with TTS compared with age- and sex-matched ST-elevation myocardial infarction (STEMI) patients on longterm follow-up
Summary
Takotsubo syndrome (TTS) is an acute and reversible cardiac condition characterized by transient left ventricular dysfunction [1]. is syndrome is distinct from acute myocardial infarction (AMI), the initial presentation has similar features to ST-segment elevatiton myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI).Cardiology Research and PracticeOwing to these similarities between AMI and TTS in clinical presentation, in the earliest phase, therapy is the same consisting of both antithrombotic and heart failure drugs [2] and early and aggressive statin therapy [3, 4].Patients with TTS have typical features (Mayo Clinic criteria) that must be identified in order to confirm the diagnosis. Takotsubo syndrome (TTS) is an acute and reversible cardiac condition characterized by transient left ventricular dysfunction [1]. Our purpose was to assess rates of all-cause mortality and survival in a series of female patients with TTS compared with age- and sex-matched STEMI patients on longterm follow-up. Takotsubo syndrome (TTS) is characterized by acute transient, stress-induced, left ventricular systolic dysfunction, generally presenting with apical ballooning. Data on long-term follow-up and survival in patients with TTS, compared with patients with ST-elevation myocardial infarction (STEMI), are scarce. To assess all-cause mortality rate and survival in a consecutive series of female patients with TTS compared with age- and sex-matched STEMI patients on long-term follow-up. The TTS group had a lower mortality rate than the STEMI group. is seems to suggest that TTS and STEMI are two different clinical entities with two different clinical outcomes
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