Comparison of Outcomes in Patients With Takotsubo Syndrome With-vs-Without Cardiogenic Shock

Syed, Moinuddin; Khan, Muhammad Zia; Alharbi, Ahoud; Munir, Muhammad Bilal; Balla, Sudarshan

doi:10.1016/j.amjcard.2020.09.014

Cited by 13 publications

(17 citation statements)

References 26 publications

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“…16 Despite female sex being a strong risk factor for TCM, most of the studies we identified suggest that it is associated with favourable short-term outcomes in TCM (Table 1). Some studies have found that male patients have poorer short-term outcomes, such as higher rates of in-hospital mortality 19,[23][24][25][26][27][28][29][30][31] and complications. 18,20,32 One retrospective study of 14 639 patients found that female patients had a lower rate of in-hospital mortality [odds ratio (OR) 0.521, 95% confidence interval (CI) 0.389-0.699].…”

Section: Factors Affecting Prognosis Of Takotsubo Cardiomyopathy Sexmentioning

confidence: 99%

“…Several studies suggest that CKD is a predictor of worse short‐term outcomes in TCM patients. 30 , 31 , 32 , 97 In one small retrospective study, 61 TCM patients were separated into three groups: estimated glomerular filtration rate (eGFR) > 60 mL/[min 1.73 m 2 ] (31 patients), eGFR 30–60 mL/[min 1.73 m 2 ] (17 patients), and eGFR < 30 mL/[min 1.73 m 2 ] (13 patients). In a multivariable Cox proportional hazard analysis, compared with the highest eGFR group, the lowest eGFR group (<30 mL/[min 1.73 m 2 ]) had a higher incidence of overall inpatient complications (HR 2.84, 95% CI 1.20–6.69), while the middle eGFR group had no difference with the highest eGFR group ( P = 0.184).…”

Section: Factors Affecting Prognosis Of Takotsubo Cardiomyopathymentioning

confidence: 99%

“…Some studies found that mood disorders predicted better short‐term outcomes in TCM patients. 30 , 31 , 33 One prospective study, registering 3719 TCM patients from Japan, found that psychiatric disorders were associated with lower inpatient mortality (OR 0.43, 95% CI 0.19–0.96). 33 Conversely, other studies have found that mood disorders were not associated with short‐term outcomes in TCM patients.…”

Section: Factors Affecting Prognosis Of Takotsubo Cardiomyopathymentioning

confidence: 99%

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Prognostic factors of Takotsubo cardiomyopathy: a systematic review

Teng

et al. 2021

ESC Heart Failure

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Takotsubo cardiomyopathy (TCM), characterized by reversible ventricular dysfunction, has similar mortality to acute coronary syndrome. With the growing interest in the diagnosis of and interventions for TCM, many risk factors had been found to affect the prognosis of TCM patients, such as age, sex, and pre-existing diseases. Because of the incomplete understanding of the pathophysiologic mechanism in TCM, evidence-based medical therapy for this condition is lacking. Early intervention on risk factors may improve the outcomes of TCM. In this review, we sought to provide up-to-date evidence on risk factors and medical therapies that affect TCM outcome. We found that male sex, physical triggers, and certain comorbidities such as chronic kidney disease, malignant disease, higher body mass index, sepsis, chronic obstructive pulmonary disease, and anaemia were associated with poor TCM prognosis. In contrast, race, hyperlipidaemia, diabetes mellitus, and mood disorders were not clearly associated with TCM prognosis. We also reviewed the effect of medical therapies on TCM outcome, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, calcium channel blockers, and statins. The evidence that these medications confer a survival benefit on TCM patients is limited. Understanding these prognostic factors could help develop risk-stratification tools for TCM and establish effective prevention and interventions for this notso-benign condition. Further multicentre clinical studies with large samples and meta-analyses of findings from previous studies are needed to address the inconsistent findings among the many potential risk factors for TCM.

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Section: Factors Affecting Prognosis Of Takotsubo Cardiomyopathy Sexmentioning

confidence: 99%

Section: Factors Affecting Prognosis Of Takotsubo Cardiomyopathymentioning

confidence: 99%

Section: Factors Affecting Prognosis Of Takotsubo Cardiomyopathymentioning

confidence: 99%

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Prognostic factors of Takotsubo cardiomyopathy: a systematic review

Teng

et al. 2021

ESC Heart Failure

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“…Apical ballooning was significantly less prevalent in patients with complications (30.4 vs. 51.7%, p = 0.010) while midventricular ballooning was more prevalent (67.4% vs. 45.2%, p = 0.006). As expectable, in-hospital complications were associated with a significantly longer hospital stay (median [IQR] 11 [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ] vs. 5 [ 3 , 4 , 5 , 6 , 7 , 8 ] days, p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…The identification of patients that may develop relevant complications during hospitalization is therefore of major clinical interest. Several factors have been identified as predictors of complications, such as male sex, high age and reduced left-ventricular function [ 8 , 9 , 10 , 11 , 12 ]. Recently, hematological indices, such as neutrophile to lymphocyte ratio (NLR), have been identified as possible predictors of in-hospital complications [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Neutrophile-Lymphocyte Ratio and Outcome in Takotsubo Syndrome

Zweiker

Pogran

Gargiulo

et al. 2022

Biology

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Background: Takotsubo syndrome (TTS) is an important type of acute heart failure with significant risk of acute complications and death. In this analysis we sought to identify predictors for in-hospital clinical outcome in TTS patients and present long-term outcomes. Methods: In this analysis from the Austrian national TTS registry, univariable and multivariable analyses were performed to identify significant predictors for severe in-hospital complications requiring immediate invasive treatment or leading to irreversible damage, such as cardiogenic shock, intubation, stroke, arrhythmias and death. Furthermore, the influence of independent predictors on long-term survival was evaluated. Results: A total of 338 patients (median age 72 years, 86.9% female) from six centers were included. Severe in-hospital complications occurred in 14.5% of patients. In multivariable analysis, high neutrophile-lymphocyte-ratio (NLR; OR 1.04 [95% CI 1.02–1.07], p = 0.009) and low LVEF (OR 0.92 [0.90–0.95] per %, p < 0.001) were significant predictors of severe in-hospital complications. Both the highest NLR tercile and the lowest LVEF tercile were significantly associated with reduced 5-year survival. Conclusions: Low LVEF and high NLR at admission were independently associated with increased in-hospital complications and reduced long-term survival in TTS patients. NLR is a new easy-to-measure tool to predict worse short- and long-term outcome after TTS.

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Opposing forces of cardiogenic shock: left ventricular outflow obstruction, severe mitral regurgitation, and left ventricular dysfunction in Takotsubo cardiomyopathy

et al. 2022

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Rates of stress (Takotsubo) cardiomyopathy have increased during the coronavirus pandemic due to social stressors, even in patients who are not infected with the virus. At times, Takotsubo cardiomyopathy (TC) may present as cardiogenic shock. Herein, we present a case during the pandemic of shock from TC secondary to left ventricular outflow tract obstruction (LVOTO), mitral regurgitation (MR), and left ventricular (LV) dysfunction. The contrasting management strategy of LVOTO, MR, and LV failure was cause for clinical challenge, and we highlight the balance of treating these opposing forces.

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Comparison of Outcomes in Patients With Takotsubo Syndrome With-vs-Without Cardiogenic Shock

Cited by 13 publications

References 26 publications

Prognostic factors of Takotsubo cardiomyopathy: a systematic review

Prognostic factors of Takotsubo cardiomyopathy: a systematic review

Neutrophile-Lymphocyte Ratio and Outcome in Takotsubo Syndrome

Opposing forces of cardiogenic shock: left ventricular outflow obstruction, severe mitral regurgitation, and left ventricular dysfunction in Takotsubo cardiomyopathy

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