Key result
Concomitant atrial fibrillation in patients with Takotsubo cardiomyopathy was associated with a significantly higher risk of the primary composite endpoint (HR 2.3; 95% CI 1.1-4.9; P<0.05).
Why the study?
Does concomitant atrial fibrillation worsen the prognosis in patients with Takotsubo cardiomyopathy?
Cohort (n=114)
No
Does concomitant atrial fibrillation worsen the prognosis in patients with Takotsubo cardiomyopathy?
Hazard Ratio: 2.3 (95% CI 1.1–4.9)
p-value: p=< 0.05
Concomitant atrial fibrillation is an independent predictor of adverse short- and long-term outcomes in patients with Takotsubo cardiomyopathy.
May identify higher-risk Takotsubo patients; leaves open whether AF-specific therapies improve outcomes.
AIMS: Previous studies revealed that patients with Takotsubo cardiomyopathy (TTC) have a higher mortality rate than the general population. Supraventricular tachycardia is a well-known complication of TTC. This study was performed to determine the short- and long-term prognostic impact of atrial fibrillation associated with TTC patients. METHODS AND RESULTS: Our institutional database constituted a collective of 114 patients diagnosed with TTC from 2003 to 2015. The patients were divided into two groups according to the presence (n = 21, 18.4%) or absence (n = 93, 81.5%) of atrial fibrillation. The endpoint was a composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), all-cause mortality, rehospitalization due to heart failure, stroke, and the recurrence of TTC. The in-hospital mortality, 30-day mortality, and long-term mortality were significantly higher in the atrial fibrillation group. Kaplan-Meier analysis indicated a significantly lower event-free survival rate over a mean follow-up of 3 years in the atrial fibrillation group than that in the non-atrial fibrillation group (log-rank, P < 0.01). In a multivariate cox regression analysis, atrial fibrillation (hazard ratio, HR 2.3, 95% confidence interval, CI: 1.1-4.9, P < 0.05) and EF ≤ 35% (HR 2.0, 95% CI: 1.1-3.8, P < 0.05) were the only independent predictors of a primary endpoint. CONCLUSION: Rates of in-hospital events and short- as well as long-term mortality were significantly higher in TTC patients suffering from atrial fibrillation compared with patients without atrial fibrillation.
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El‐Battrawy et al. (2016) conducted a cohort in Takotsubo cardiomyopathy (n=114). Atrial fibrillation vs. Absence of atrial fibrillation was evaluated on Composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), all-cause mortality, rehospitalization due to heart failure, stroke, and the recurrence of TTC (HR 2.3, 95% CI 1.1-4.9, p=< 0.05). Concomitant atrial fibrillation in patients with Takotsubo cardiomyopathy was associated with a significantly higher risk of the primary composite endpoint (HR 2.3; 95% CI 1.1-4.9; P<0.05).
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