Key result
Takotsubo syndrome patients had a higher frequency of psychiatric, neurological, and pulmonary pre-existing diseases compared to STEMI patients, but these comorbidities and cardiovascular risk factors did not independently predict adverse short-term outcomes.
Why the study?
Little is known about the frequency and effects of cardiovascular risk factors and pre-existing diseases on short-term outcomes in Takotsubo syndrome compared to STEMI.
Does the frequency of cardiovascular risk factors and pre-existing diseases differ between Takotsubo syndrome and STEMI, and do they predict short-term outcomes in Takotsubo syndrome?
Observational (n=305)
Yes
Does the frequency of cardiovascular risk factors and pre-existing diseases differ between Takotsubo syndrome and STEMI, and do they predict short-term outcomes in Takotsubo syndrome?
Absolute Event Rate: 20% vs 15%
p-value: p=0.23
Psychiatric, neurological, and pulmonary pre-existing diseases are more common in Takotsubo syndrome than in STEMI, but traditional cardiovascular risk factors and pre-existing diseases do not independently predict short-term adverse outcomes in Takotsubo syndrome.
CVRF and pre-existing diseases lack independent prognostic value for short-term TTS outcomes; leaves open their role in longer-term risk stratification.
BACKGROUND: The effects of cardiovascular risk factors (CVRF) on the development of most acute cardiac conditions are well established; however, little is known about the frequency and effects of CVRF in Takotsubo syndrome (TTS) patients. OBJECTIVE: The aim of our study was to compare the frequency of CVRF and pre-existing diseases (PD) of TTS patients to ST-elevation myocardial infarction (STEMI) patients and analyze their effects on short-term outcome. METHODS: We analyzed the frequency of CVRF (hypertension, hyperlipidemia, type II diabetes mellitus, smoking, chronic kidney disease, family history) as well as somatic and psychiatric PD at admission in TTS patients and compared them with STEMI patients. Their effect on short-term outcome was calculated using a combined endpoint of cardiogenic shock, cardiopulmonary resuscitation, mechanical ventilation, and/or in-hospital death. RESULTS: In total, 150 TTS and 155 STEMI patients were included in our study. We observed a higher frequency of psychiatric (30% vs. 7%, p < 0.001), neurological (5% vs. 0%, p = 0.01), and pulmonary (18% vs. 5%, p < 0.001) PD in TTS patients as compared to STEMI patients. There were less smokers (47% vs. 61%, p = 0.03) and patients with hyperlipidemia (24% vs. 51%, p < 0.001) in the TTS cohort than in the STEMI cohort. None of the CVRF or PD behaved as an independent predictor for adverse short-term outcome in TTS patients. CONCLUSION: Psychiatric, neurological, and pulmonary pre-existing diseases are more common in TTS than in STEMI patients. Interestingly, PD and CVRF do not seem to have any impact on the short-term outcome of TTS patients.
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Mousavi et al. (2024) conducted an observational in Takotsubo syndrome and ST-elevation myocardial infarction (n=305). Takotsubo syndrome vs. ST-elevation myocardial infarction (STEMI) was evaluated on Adverse in-hospital outcome (combined endpoint of cardiogenic shock, cardiopulmonary resuscitation, catecholamine use, mechanical ventilation, and/or in-hospital death) (p=0.23). Takotsubo syndrome patients had a higher frequency of psychiatric, neurological, and pulmonary pre-existing diseases compared to STEMI patients, but these comorbidities and cardiovascular risk factors did not independently predict adverse short-term outcomes.
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