Secondary Takotsubo syndrome occurred in 37% of patients and was associated with higher cardiogenic shock (27.6% vs 6.3%, p<0.001) and increased hospital mortality (15.5% vs 6.2%, p=0.057) compared to
Does secondary Takotsubo syndrome have a worse prognosis compared to primary Takotsubo syndrome?
Secondary Takotsubo syndrome is associated with a significantly higher rate of cardiogenic shock and a trend toward higher hospital mortality compared to primary Takotsubo syndrome.
Absolute Event Rate: 0% vs 0%
Abstract Background Large international registries of patients with Takotsubo syndrome (TTS) suggest that the prognosis and mortality of patients with TTS is comparable and in some cases even worse, than in patients with acute coronary syndrome. However, TTS represents a wide spectrum of conditions from completely benign to cardiogenic shock and malignant arrhythmias. Aim Takotsubo syndrome often develops subsequently after initial hospitalization for serious non-cardiac disease. The incidence of such „secondary" TTS is rising due to closer interdisciplinary cooperation. The aim of the study is to compare patients in those TTS was the primary reason for admission with patients with secondary TTS. Sample and Methodology Patients hospitalized with TTS in a large university hospital were identified and prospectively included in this monocentric study between 2013 and 2023. A total of 155 patients were diagnosed with TTS. All of them had to meet the international InterTAK diagnostic criteria. We divided the patients into two groups: Group A (primary TTS) included patients who were admitted with primarily acute cardiac involvement and the suspicion of TTS which we definitively concluded as TTS. Group B (secondary TTS) included patients admitted for non-cardiac severe disability (like trauma, stroke, acute pulmonary disease and others), who were diagnosed with TTS based on new onset of symptoms after initial hospitalization. Results Group A (primary TTS) included 97 patients and there were 58 patients in the Group B (secondary TTS). We didn’t recognise any diffrences in the baseline characteristics: 91% female in both groups with the same average age of 71 years. Ejection fraction in Group A and B was 36,1±7,6% vs. 34,5±6,6% (p=0.306), respectively. The time from admission to development of diagnosed secondary TTS was 5.3±5.4 days. Development of cardiogenic shock was seen in group A in 6.3% vs. 27.6% in group B (p0.001). The hospital mortality in group A was 6.2% vs. 15.5% in group B (p=0.057). Conclusion More than one third of patients from our registry had secondary type of Takotsubo syndrome induced by another primary non-cardiac disease. Eventhough primary and secondary type of TTS did not differ in age and ejection fraction, secondary type of TTS was associated with worse prognosis. The outcome of patients with the secondary form is certainly significantly influenced by the severe primary non-cardiac involvement. On the other hand, the development of TTS in these patients further worsens the course of their disease.
Bartoskova et al. (Sat,) reported a other. Secondary Takotsubo syndrome occurred in 37% of patients and was associated with higher cardiogenic shock (27.6% vs 6.3%, p<0.001) and increased hospital mortality (15.5% vs 6.2%, p=0.057) compared to.