Clinical features and outcomes of takotsubo (stress) cardiomyopathy

Templin, C. et al. (2015) Clinical features and outcomes of takotsubo (stress) cardiomyopathy. New England Journal of Medicine, 373(10), pp. 929-938. (doi: 10.1056/NEJMoa1406761) (PMID:26332547)

Abstract

METHODS The International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age- and sex-matched patients who had an acute coronary syndrome. Full Text of Methods... RESULTS Of 1750 patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Among patients with takotsubo cardiomyopathy, as compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%) (P<0.001 for both comparisons). Rates of severe in-hospital complications including shock and death were similar in the two groups (P=0.93). Physical triggers, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission were independent predictors for in-hospital complications. During long-term follow-up, the rate of major adverse cardiac and cerebrovascular events was 9.9% per patient-year, and the rate of death was 5.6% per patient-year. Full Text of Results... CONCLUSIONS Patients with takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome. This condition represents an acute heart failure syndrome with substantial morbidity and mortality. (Funded by the Mach-Gaensslen Foundation and others;

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ford, Professor Ian
• Authors: Templin, C., Ghadri, J. R., Diekmann, J., Napp, L. C., Bataiosu, D. R., Jaguszewski, M., Cammann, V. L., Sarcon, A., Geyer, V., Neumann, C. A., Seifert, B., Hellermann, J., Schwyzer, M., Eisenhardt, K., Jenewein, J., Franke, J., Katus, H. A., Burgdorf, C., Schunkert, H., Moeller, C., Thiele, H., Bauersachs, J., Tschöpe, C., Schultheiss, H.-P., Laney, C. A., Rajan, L., Michels, G., Pfister, R., Ukena, C., Böhm, M., Erbel, R., Cuneo, A., Kuck, K.-H., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Cuculi, F., Banning, A., Fischer, T. A., Vasankari, T., Airaksinen, K.E. J., Fijalkowski, M., Rynkiewicz, A., Pawlak, M., Opolski, G., Dworakowski, R., MacCarthy, P., Kaiser, C., Osswald, S., Galiuto, L., Crea, F., Dichtl, W., Franz, W. M., Empen, K., Felix, S. B., Delmas, C., Lairez, O., Erne, P., Bax, J. J., Ford, I., Ruschitzka, F., Prasad, A., and Lüscher, T. F.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: New England Journal of Medicine
• Publisher: Massachusetts Medical Society
• ISSN: 0028-4793
• ISSN (Online): 1533-4406