Key result
The diagnosis of takotsubo cardiomyopathy in patients presenting with STEMI increased significantly in the later period (2008-2013) compared to the early period (2002-2007) (0.7% vs 0.3%, OR 2.4).
Why the study?
Has the diagnosed prevalence of takotsubo cardiomyopathy increased over time in patients presenting with STEMI?
Observational (n=8,413)
No
Has the diagnosed prevalence of takotsubo cardiomyopathy increased over time in patients presenting with STEMI?
Odds Ratio: 2.4 (95% CI 1.2–4.6)
Absolute Event Rate: 0.7% vs 0.3%
p-value: p=0.009
The diagnosis of takotsubo cardiomyopathy among patients presenting with STEMI has increased over time, likely due to heightened clinical awareness, though overall prevalence remains low at 0.5%.
May indicate greater diagnostic awareness in STEMI; leaves open whether true incidence is rising.
BACKGROUND: Takotsubo cardiomyopathy often presents with the clinical signs of ST-elevation myocardial infarction (STEMI). The increase in scientific publications addressing this relatively rare condition may result in higher awareness and diagnosis of takotsubo cardiomyopathy. AIM: To assess the observed prevalence per year of takotsubo cardiomyopathy in a large registry of patients with STEMI, during a 12-year inclusion period. METHOD: All patients presenting with STEMI at a large regional cardiology clinic were entered into a database (n = 8,413, mean age 63 ± 13 years). Takotsubo cardiomyopathy was diagnosed in 42 patients (0.5 %). Years of evaluation were defined as 'early years' (January 2002 to December 2007; n = 4350) and 'later years' (January 2008 to December 2013). Multivariable analyses were performed to adjust for differences in demographical and clinical variables. RESULTS: In later years, the age of STEMI patients was slightly higher (64 ± 13 vs. 63 ± 13 years, p < 0.001), with more patients with clinical symptoms of shock (10 vs. 7 %, p < 0.001) or a history of percutaneous coronary intervention or hypertension (10 vs. 8 %, p = 0.001 and 37 vs. 34 %, p < 0.001). Smoking and a positive family history were less often observed during later years (39 vs. 46 %, p < 0.001 and 37 vs. 42 % p < 0.001). Patients with takotsubo cardiomyopathy were more often female (81 vs. 27 %, p = 0.001). Takotsubo cardiomyopathy was more often diagnosed in the later period (0.7 vs. 0.3 %, OR 2.4, 95 % CI 1.2-4.6, p = 0.009). The higher prevalence of takotsubo cardiomyopathy in recent years remained significant after adjustment for differences in patient characteristics (OR 2.1, 95 % CI 1.1-4.3). CONCLUSION: Takotsubo cardiomyopathy is currently more often diagnosed in patients with STEMI compared with in earlier years. This is probably due to the increased scientific and clinical awareness among doctors, but the prevalence is still low.
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Otten et al. (2016) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=8,413). Later time period (2008-2013) vs. Early time period (2002-2007) was evaluated on Diagnosis of takotsubo cardiomyopathy (OR 2.4, 95% CI 1.2-4.6, p=0.009). The diagnosis of takotsubo cardiomyopathy in patients presenting with STEMI increased significantly in the later period (2008-2013) compared to the early period (2002-2007) (0.7% vs 0.3%, OR 2.4).
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