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20.08.2021 | original article

Long-term outcome in patients with takotsubo syndrome

A single center study from Vienna

Zeitschrift:
Wiener klinische Wochenschrift
Autoren:
Dr. med. Edita Pogran, Ahmed Abd El-Razek, Laura Gargiulo, Valerie Weihs, Christoph Kaufmann, Samuel Horváth, Alexander Geppert, Michael Nürnberg, Emil Wessely, Peter Smetana, Kurt Huber
Wichtige Hinweise

Availability of data and material

Data were stored on local memory devices. Investigator Kurt Huber and subinvestigators—Edita Pogran, Laura Gargiulo, Ahmed Abd-El Razek—had access to the data. Other authors performed coronary angiography in takotsubo patients included into the study and manuscript correction.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Summary

Background

There is an increasing amount of evidence suggesting multiple fatal complications in takotsubo syndrome; however, findings on the long-term outcome are scarce and show inconsistent evidence.

Methods

This is a single center study of long-term prognosis in takotsubo patients admitted to the Klinik Ottakring, Vienna, Austria, from September 2006 to August 2019. We investigated the clinical features, prognostic factors and outcome of patients with takotsubo syndrome. Furthermore, survivors and non-survivors and patients with a different cause of death were compared.

Results

Overall, 147 patients were included in the study and 49 takotsubo patients (33.3%) died during the follow-up, with a median of 126 months. The most common cause of death was a non-cardiac cause (71.4% of all deaths), especially malignancies (26.5% of all deaths). Moreover, non-survivors were older and more often men with more comorbidities (chronic kidney disease, malignancy). Patients who died because of cardiovascular disease were older and more often women than patients who died due to non-cardiovascular cause. Adjusted analysis showed no feature of an independent predictor of cardiovascular mortality for takotsubo patients. Female gender (HR = 0.32, CI: 0.16–0.64, p < 0.001), cancer (HR = 2.35, CI: 1.15–4.8, p = 0.019) and chronic kidney disease (HR = 2.61, CI: 1.11–6.14, p = 0.028) showed to be independent predictors of non-cardiovascular mortality.

Conclusion

Long-term prognosis of takotsubo patients is not favorable, mainly due to noncardiac comorbidities. Hence, consequent outpatient care in regular intervals after a takotsubo event based on risk factor control and early detection of malignancies seems justified.

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