Long-Term Prognosis of Patients With Takotsubo Syndrome

  • Jelena R Ghadri
  • Ken Kato
  • Victoria L Cammann
  • Sebastiano Gili
  • Stjepan Jurisic
  • Davide Di Vece
  • Alessandro Candreva
  • Katharina J Ding
  • Jozef Micek
  • Konrad A Szawan
  • Beatrice Bacchi
  • Rahel Bianchi
  • Rena A Levinson
  • Manfred Wischnewsky
  • Burkhardt Seifert
  • Susanne A Schlossbauer
  • Rodolfo Citro
  • Eduardo Bossone
  • Thomas Münzel
  • Maike Knorr
  • Susanne Heiner
  • Fabrizio D'Ascenzo
  • Jennifer Franke
  • Annahita Sarcon
  • L Christian Napp
  • Milosz Jaguszewski
  • Michel Noutsias
  • Hugo A Katus
  • Christof Burgdorf
  • Heribert Schunkert
  • Holger Thiele
  • Johann Bauersachs
  • Carsten Tschöpe
  • Burkert M Pieske
  • Lawrence Rajan
  • Guido Michels
  • Roman Pfister
  • Alessandro Cuneo
  • Claudius Jacobshagen
  • Gerd Hasenfuß
  • Mahir Karakas
  • Wolfgang Koenig
  • Wolfgang Rottbauer
  • Samir M Said
  • Ruediger C Braun-Dullaeus
  • Adrian Banning
  • Florim Cuculi
  • Richard Kobza
  • Thomas A Fischer
  • Tuija Vasankari
  • K E Juhani Airaksinen
  • Grzegorz Opolski
  • Rafal Dworakowski
  • Philip MacCarthy
  • Christoph Kaiser
  • Stefan Osswald
  • Leonarda Galiuto
  • Filippo Crea
  • Wolfgang Dichtl
  • Klaus Empen
  • Stephan B Felix
  • Clément Delmas
  • Olivier Lairez
  • Ibrahim El-Battrawy
  • Ibrahim Akin
  • Martin Borggrefe
  • John Horowitz
  • Martin Kozel
  • Petr Tousek
  • Petr Widimský
  • Ekaterina Gilyarova
  • Alexandra Shilova
  • Mikhail Gilyarov
  • David E Winchester
  • Christian Ukena
  • Jeroen J Bax
  • Abhiram Prasad
  • Michael Böhm
  • Thomas F Lüscher
  • Frank Ruschitzka
  • Christian Templin

Abstract

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).

Bibliographical metadata

Original languageEnglish
ISSN0735-1097
DOIs
Publication statusPublished - 21.08.2018
PubMed 30115226