Key result
Takotsubo syndrome linked to ~15-point lower long-term mortality vs. matched STEMI in females.
Why the study?
Data on long-term follow-up and survival in patients with Takotsubo syndrome compared with patients with STEMI were scarce.
Does Takotsubo syndrome have a different long-term all-cause mortality rate compared to ST-elevation myocardial infarction in female patients?
Cohort (n=169)
No
Does Takotsubo syndrome have a different long-term all-cause mortality rate compared to ST-elevation myocardial infarction in female patients?
Female patients with Takotsubo syndrome exhibit significantly better long-term survival compared to age-matched female patients with STEMI.
Answers are grounded in this paper and cite their sources.
Supports more favorable long-term survival in female TTS than STEMI; leaves open confounding and needs prospective validation.
Background . Takotsubo syndrome (TTS) is characterized by acute transient, stress-induced, left ventricular systolic dysfunction, generally presenting with apical ballooning. It can mimic an acute coronary syndrome, but with a milder increase in cardiac enzymes and without culprit coronary artery disease on angiography. Data on long-term follow-up and survival in patients with TTS, compared with patients with ST-elevation myocardial infarction (STEMI), are scarce. Purpose . To assess all-cause mortality rate and survival in a consecutive series of female patients with TTS compared with age- and sex-matched STEMI patients on long-term follow-up. Methods and Results . We collected data of 65 TTS female patients (TTS group) with a mean age of 73.42 ± 11.35 years from 2001 to 2013. Collection of follow-up information was concluded for all patients in 2016. To compare the mortality and survival of TTS patients with those of the STEMI population, we used data from our STEMI Registry, a prospective registry of 7446 STEMI patients admitted from 2001 to 2013 to our cath-lab for primary percutaneous coronary intervention (p-PCI). From the registry, we selected 104 STEMI patients (STEMI group) comparable to our TTS group in terms of age (mean age of 72.33 ± 11.92 years) and sex. On follow-up examination after a median of 1000 days, the TTS group had a lower all-cause mortality rate than the STEMI group (7.69% versus 23.08%). This difference was statistically different between the two groups (log-rank test, p value = 0.03). Conclusions . In our study, TTS and STEMI patients displayed a statistically significant difference in long-term survival. Specifically, the TTS group had a lower mortality rate than the STEMI group. This seems to suggest that TTS and STEMI are two different clinical entities with two different clinical outcomes.
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Massobrio et al. (2019) conducted a cohort in Takotsubo syndrome vs ST-elevation myocardial infarction (n=169). Takotsubo syndrome vs. ST-elevation myocardial infarction (STEMI) was evaluated on All-cause mortality (p=0.03). Female patients with Takotsubo syndrome had a significantly lower long-term all-cause mortality rate compared to matched patients with ST-elevation myocardial infarction (7.69% vs 23.08%, p=0.03).
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