Takotsubo syndrome – fatal prognosis of patients with low body mass index in 5-year follow-up

Abstract

Introduction: The clinical courses of takotsubo syndrome (TS) and of acute coronary syndromes (ACS) seem to be very similar. However, there is limited knowledge about risk factors of poor outcomes. Low body mass index worsens the prognosis of patients with cardiovascular diseases, especially those undergoing surgical treatment. The aim of the study was to evaluate the influence of the body mass index (BMI) on the prognosis in patients diagnosed with TS. Material and methods: Eighty patients aged 15-89 (mean: 67.9 years), 74 women and 6 men with TS diagnosis according to Mayo Clinic diagnostic criteria were divided into 3 groups: low body mass (BMI < 18.5 kg/m 2), normal body mass (18.5 ≥ BMI < 25 kg/m 2) and excessive body mass (BMI ≥ 25 kg/m 2). Results: Patients with low BMI were older, but with less prevalent risk factors such as hypertension, hypercholesterolemia and positive family history of coronary artery disease and more frequent risk factors such as cigarette smoking, chronic obstructive pulmonary disease (COPD), depressive and anxiety disorders as well as malignancy. They also had higher haemoglobin, lower troponin, creatine kinase, C-reactive protein and lipid fractions. The highest annual, 3-year and 5-year mortality was observed in the group with BMI < 18.5 kg/m 2. None of the patients with low BMI survived the 5-year follow-up period (100% vs. 25% vs. 15.2%; p < 0.0001). In group III, mortality among overweight patients (25 ≥ BMI < 30 kg/m 2) was 8.3%, and in obese people (BMI ≥ 30 kg/m 2) 1 out 5 patients died during follow-up. Conclusions: The majority of typical cardiovascular risk factors are less frequently observed in patients with TS and low body mass. Early prognosis for TS patients and low BMI is relatively favourable, whereas the 5-year follow-up is associated with extremely high mortality. Overweight patients have the best prognosis in the long-term follow-up.

A Case of Wernicke Encephalopathy Secondary to Anorexia Nervosa Complicated by Refeeding Syndrome and Takotsubo Cardiomyopathy

“…More importantly, treatment of the patient’s neurologic condition and metabolic support with refeeding reversed her acquired cardiomyopathy and she returned to baseline cardiovascular function. However, a recent study showed a good early prognosis for patients with low BMI and TC, but mortality at 5-year follow-up was very high [ 13 ].…”

The Association Between Hyperlipidemia and In-Hospital Outcomes in Takotsubo Cardiomyopathy

“…The variables in our study include patient demographics (age, sex, race, household income, primary payer for the hospitalization) and hospital demographics (hospital type, hospital size and region). To further reduce selection bias, we included common cardiovascular comorbidities, such as smoking, hypertension, obstructive sleep apnea (OSA), peripheral artery disease (PAD), and other reported risk factors for TCM including chronic obstructive pulmonary disease (COPD), 21,22 anxiety 23 and depressive disorders, 18 obesity, 24 diabetes mellitus (DM), 25 chronic kidney disease (CKD) 26 and sepsis. 27 In-Hospital Outcomes…”

Long-term prognosis in patients suffering from myocardial infarction with non-obstructive coronary arteries, ST-segment elevation myocardial infarction, infective myocarditis and tako-tsubo cardiomyopathy – all-cause mortality comparison

“…Due to the fact that the clinical and echocardiographic image of patients with anterior wall STEMI is often similar to that observed in TTC, we selected patients with this diagnosis for long-term observation within the aspect of all-cause mortality, as well as major adverse cardiac and cerebrovascular events (MACCE) [2]. It has been suggested that TCC is not such a trivial condition and patients with TTC, especially males, have poor prognosis compared to STEMI and non-ST-segment elevation myocardial infarction (NSTEMI) patients [3][4][5]. Also, comparisons between MINOCA and TTC patients have been reported [3][4][5].…”

“…It has been suggested that TCC is not such a trivial condition and patients with TTC, especially males, have poor prognosis compared to STEMI and non-ST-segment elevation myocardial infarction (NSTEMI) patients [3][4][5]. Also, comparisons between MINOCA and TTC patients have been reported [3][4][5]. In several studies, the survival of MINOCA patients has been compared to those experiencing myocardial infarction with obstructive coronary arteries (MI-CAD), showing poorer outcomes in the latter group, mainly due to repeated revascularisation [6][7][8][9].…”