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Long-Term Prognosis of Patients With Takotsubo Syndrome.
Journal article

Long-Term Prognosis of Patients With Takotsubo Syndrome.

  • Ghadri JR University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Kato K University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Cammann VL University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Gili S University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland; Division of Cardiology, Department of Medical Sciences, AOU Citta della Salute e della Scienza, University of Turin, Turin, Italy.
  • Jurisic S University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Di Vece D University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Candreva A University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Ding KJ University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Micek J University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Szawan KA University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Bacchi B University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Bianchi R University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Levinson RA University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland; Division of Biological Sciences, University of California, San Diego, La Jolla, California.
  • Wischnewsky M Department of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
  • Seifert B Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
  • Schlossbauer SA University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Citro R Heart Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
  • Bossone E Heart Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
  • Münzel T Cardiology 1, Center for Cardiology, University Medical Center Mainz, Mainz, Germany.
  • Knorr M Cardiology 1, Center for Cardiology, University Medical Center Mainz, Mainz, Germany.
  • Heiner S Cardiology 1, Center for Cardiology, University Medical Center Mainz, Mainz, Germany.
  • D'Ascenzo F Division of Cardiology, Department of Medical Sciences, AOU Citta della Salute e della Scienza, University of Turin, Turin, Italy.
  • Franke J Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Sarcon A University of Southern California, Keck School of Medicine, Los Angeles, California.
  • Napp LC Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Jaguszewski M First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
  • Noutsias M Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Halle (Saale), Germany.
  • Katus HA Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Burgdorf C Heart and Vascular Centre Bad Bevensen, Bad Bevensen, Germany.
  • Schunkert H Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
  • Thiele H Heart Center Leipzig, University Hospital, Department of Internal Medicine/Cardiology, Leipzig, Germany.
  • Bauersachs J Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Tschöpe C Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany.
  • Pieske BM Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany.
  • Rajan L TJ Health Partners Heart and Vascular, Glasgow, Kentucky.
  • Michels G Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany.
  • Pfister R Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany.
  • Cuneo A Krankenhaus "Maria Hilf" Medizinische Klinik, Stadtlohne, Germany.
  • Jacobshagen C Clinic for Cardiology and Pneumology, Georg August University Goettingen, Goettingen, Germany.
  • Hasenfuß G Clinic for Cardiology and Pneumology, Georg August University Goettingen, Goettingen, Germany.
  • Karakas M 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.
  • Koenig W Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
  • Rottbauer W Department of Internal Medicine II-Cardiology, University of Ulm, Medical Center, Ulm, Germany.
  • Said SM Internal Medicine/Cardiology, Angiology, and Pneumology, Magdeburg University, Magdeburg, Germany.
  • Braun-Dullaeus RC Internal Medicine/Cardiology, Angiology, and Pneumology, Magdeburg University, Magdeburg, Germany.
  • Banning A Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, United Kingdom.
  • Cuculi F Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland.
  • Kobza R Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland.
  • Fischer TA Department of Cardiology, Kantonsspital Winterthur, Winterthur, Switzerland.
  • Vasankari T Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
  • Airaksinen KEJ Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
  • Opolski G Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
  • Dworakowski R Department of Cardiology, Kings College Hospital, Kings Health Partners, London, United Kingdom.
  • MacCarthy P Department of Cardiology, Kings College Hospital, Kings Health Partners, London, United Kingdom.
  • Kaiser C Department of Cardiology, University Hospital Basel, Basel, Switzerland.
  • Osswald S Department of Cardiology, University Hospital Basel, Basel, Switzerland.
  • Galiuto L Department of Cardiovascular Sciences, Catholic University of the Sacred Heart Rome, Rome, Italy.
  • Crea F Department of Cardiovascular Sciences, Catholic University of the Sacred Heart Rome, Rome, Italy.
  • Dichtl W University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria.
  • Empen K University Medicine Greifswald, Department of Internal Medicine B, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.
  • Felix SB University Medicine Greifswald, Department of Internal Medicine B, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.
  • Delmas C Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France.
  • Lairez O Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France.
  • El-Battrawy I 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.
  • Akin I 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.
  • Borggrefe M 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.
  • Horowitz J Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia.
  • Kozel M Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
  • Tousek P Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
  • Widimský P Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
  • Gilyarova E Intensive Coronary Care Unit, Moscow City Hospital #1 named after N. Pirogov, Moscow, Russia.
  • Shilova A Intensive Coronary Care Unit, Moscow City Hospital #1 named after N. Pirogov, Moscow, Russia.
  • Gilyarov M Intensive Coronary Care Unit, Moscow City Hospital #1 named after N. Pirogov, Moscow, Russia.
  • Winchester DE Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida.
  • Ukena C Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
  • Bax JJ Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands.
  • Prasad A Division of Cardiovascular Diseases Mayo Clinic, Rochester, Minnesota.
  • Böhm M Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
  • Lüscher TF Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Switzerland; Royal Brompton and Harefield Hospitals Trust and Imperial College, London, United Kingdom.
  • Ruschitzka F University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Templin C University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. Electronic address: christian.templin@usz.ch.
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  • 2018-08-18
Published in:
  • Journal of the American College of Cardiology. - 2018
Takotsubo syndrome
acute coronary syndrome
broken heart syndrome
classification
outcome
stress factor
Acute Coronary Syndrome
Aged
Aged, 80 and over
Electroencephalography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mortality
Nervous System Diseases
Prognosis
Registries
Stress, Psychological
Takotsubo Cardiomyopathy
Time Factors
English BACKGROUND
Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive.


OBJECTIVES
This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers.


METHODS
Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions.


RESULTS
Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients.


CONCLUSIONS
Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621).
Language
  • English
Open access status
bronze
Identifiers
Persistent URL
https://sonar.ch/global/documents/94768
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