Trigger‐Associated Clinical Implications and Outcomes in Takotsubo Syndrome: Results From the Multicenter GEIST Registry-Reference-Cited by-同舟云学术

Trigger‐Associated Clinical Implications and Outcomes in Takotsubo Syndrome: Results From the Multicenter GEIST Registry

Published:2023-07-18 Issue:14 Volume:12 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Pätz Toni¹^ORCID,Santoro Francesco²^ORCID,Cetera Rosa²,Ragnatela Ilaria²^ORCID,El‐Battrawy Ibrahim³⁴^ORCID,Mezger Matthias¹^ORCID,Rawish Elias¹⁵,Andrés‐Villarreal Mireia⁶^ORCID,Almendro‐Delia Manuel⁷^ORCID,Martinez‐Sellés Manuel⁸^ORCID,Uribarri Aitor⁶^ORCID,Pérez‐Castellanos Alberto⁹^ORCID,Guerra Federico¹⁰,Novo Giuseppina¹¹^ORCID,Mariano Enrica¹²,Musumeci Maria Beatrice¹³^ORCID,Arcari Luca¹⁴^ORCID,Cacciotti Luca¹⁴,Montisci Roberta¹⁵^ORCID,Akin Ibrahim⁴^ORCID,Thiele Holger¹⁶^ORCID,Brunetti Natale Daniele²^ORCID,Vedia Oscar¹⁷^ORCID,Núñez‐Gil Ivan J.¹⁷^ORCID,Eitel Ingo¹⁵^ORCID,Stiermaier Thomas¹⁵^ORCID

Affiliation:

1. Medical Clinic II University Heart Center Lübeck Lübeck Germany

2. Department of Medical and Surgery Sciences University of Foggia Italy

3. Department of Cardiology and Angiology Bergmannsheil University Hospitals, Ruhr University of Bochum Bochum Germany

4. University of Mannheim, DZHK Partner Site Heidelberg/Mannheim, ECAS (European Center of Angioscience) Mannheim Germany

5. German Center for Cardiovascular Research (DZHK), Partner Site Hamburg‐Kiel‐Lübeck Lübeck Germany

6. Servicio de Cardiología Hospital Universitario Vall d’Hebron Barcelona Spain

7. Servicio de Cardiología, Hospital Virgen Macarena Sevilla Spain

8. Cardiology Department Hospital General Universitario Gregorio Marañon, CIBERCV. Universidad Europea, Universidad Complutense Madrid Spain

9. Servicio de Cardiología Hospital Universitario Son Espases Palma Spain

10. Cardiology and Arrhythmology Clinic Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi” Ancona Italy

11. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Cardiology Unit University of Palermo, University Hospital P. Giaccone Palermo Italy

12. Department of Cardiology Tor Vergata University Italy

13. Cardiology Department, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology Sapienza University of Rome Rome Italy

14. Institute of Cardiology, Madre Giuseppina Vannini Hospital Rome Italy

15. Clinical Cardiology, Department of Medical Science and Public Health University of Cagliari Cagliari Italy

16. Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute Leipzig Germany

17. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Universidad Complutense de Madrid Madrid Spain

Abstract

Background Takotsubo syndrome is usually triggered by a stressful event. The type of trigger seems to influence the outcome and should therefore be considered separately. Methods and Results Patients included in the GEIST (German‐Italian‐Spanish Takotsubo) registry were categorized according to physical trigger (PT), emotional trigger (ET), and no trigger (NT) of Takotsubo syndrome. Clinical characteristics as well as outcome predictors were analyzed. Overall, 2482 patients were included. ET was detected in 910 patients (36.7%), PT in 885 patients (34.4%), and NT was observed in 717 patients (28.9%). Compared with patients with PT or NT, patients with ET were younger, less frequently men, and had a lower prevalence of comorbidities. Adverse in‐hospital events (NT: 18.8% versus PT: 27.1% versus ET: 12.1%, P <0.001) and long‐term mortality rates (NT: 14.4% versus PT: 21.6% versus ET: 8.5%, P <0.001) were significantly lower in patients with ET. Increasing age ( P <0.001), male sex ( P =0.007), diabetes ( P <0.001), malignancy ( P =0.002), and a neurological disorder ( P <0.001) were associated with a higher risk of long‐term mortality, while chest pain ( P =0.035) and treatment with angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker ( P =0.027) were confirmed as independent predictors for a lower risk of long‐term mortality. Conclusions Patients with ET have better clinical conditions and a lower mortality rate. Increasing age, male sex, malignancy, a neurological disorder, chest pain, angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker, and diabetes were confirmed as predictors of long‐term mortality.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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