Key result
Takotsubo syndrome linked to ~2.3-fold higher long-term thromboembolic events vs ACS.
Why the study?
Thromboembolic events are a common complication in Takotsubo syndrome, but data on their long-term incidence compared with ACS are lacking.
Does Takotsubo syndrome increase the incidence of thromboembolic events compared to acute coronary syndrome?
Cohort (n=276)
No
Does Takotsubo syndrome increase the incidence of thromboembolic events compared to acute coronary syndrome?
Absolute Event Rate: 21% vs 9%
p-value: p=<.01
Patients with Takotsubo syndrome experience a substantially higher long-term risk of thromboembolic events compared with matched patients with acute coronary syndrome, underscoring the importance of vigilance and potential role for anticoagulation.
Supports heightened thromboembolic vigilance after Takotsubo syndrome; leaves open whether anticoagulation improves outcomes in prospective trials.
Thromboembolic events are a common complication in Takotsubo syndrome (TTS). However, their long-term incidence compared with acute coronary syndrome (ACS) is lacking. In-hospital and long-term incidence of thromboembolic events of 138 consecutive patients with TTS were compared with 138 sex- and age-matched patients with ACS. Predictors of events were analyzed. The incidence of thromboembolic events in TTS was 2-fold higher than ACS (21% vs 9%; P < .01) over a mean follow-up of 5 years. Although the left ventricular ejection fraction (LVEF) at event was significantly lower in TTS compared with ACS (38% [9%] vs 54% [11%]; P < .01), the follow-up LVEF was comparable. Patients with TTS suffering from thromboembolic events were more often treated with anticoagulation compared with ACS (44.8% vs 8.3%, P = .03). However, more patients presenting with ACS (100% vs 48.3%; P < .01) were discharged on aspirin. Only elevated C-reactive protein was a predictor of thromboembolic events using multivariate analysis (hazard ratio 1.1, 95% confidence interval, 1.0-1.2; P < .01). In conclusion, the risk of thromboembolic events in TTS was significantly higher than the risk of thromboembolic events in ACS over a mean follow-up of 5 years.
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El‐Battrawy et al. (2019) conducted a cohort in Takotsubo syndrome vs Acute coronary syndrome (n=276). Takotsubo syndrome vs. Acute coronary syndrome was evaluated on Incidence of thromboembolic events (p=<.01). Takotsubo syndrome was associated with a significantly higher long-term incidence of thromboembolic events compared with acute coronary syndrome (21% vs 9%; p<0.01) over a mean follow-up of 5 years.
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