Key result
Postdischarge survivors of Takotsubo syndrome had a higher long-term mortality risk compared to a community cohort without prior CVD (HR 2.00; 95% CI 1.26-3.17; p=0.003), but better survival than ACS.
Why the study?
Does Takotsubo syndrome increase long-term postdischarge mortality compared to patients without prior CVD and those with ACS?
Cohort (n=225)
Does Takotsubo syndrome increase long-term postdischarge mortality compared to patients without prior CVD and those with ACS?
Hazard Ratio: 2 (95% CI 1.26–3.17)
p-value: p=0.003
Postdischarge survivors of Takotsubo syndrome have a higher long-term mortality risk than the general population, primarily driven by non-cardiac causes, though their prognosis remains better than that of ACS survivors.
Takotsubo survivors may warrant extended surveillance; leaves open whether interventions can reduce excess noncardiac mortality.
Objective: Takotsubo syndrome (TS) mimics acute coronary syndrome (ACS) but has a distinct pathophysiology. While in-hospital adverse outcomes appear similar to those presenting with an ACS, data on longer term postdischarge risk are conflicting. This study sought to assess the long-term prognosis of patients discharged alive after TS. Methods: The clinical profile and in-hospital and long-term outcomes were prospectively assessed in consecutive patients with TS. Survival in patients with TS was compared with two representative age-matched and gender-matched comparison cohorts: a hospitalised ACS cohort and a community cohort without known cardiovascular disease (CVD). Results: Two hundred and-twenty-five patients with TS (216 women, mean age 63.7±11.8 years) were included. In-hospital mortality was 1.8% and 1.9% for patients with TS and ACS, respectively. Of the 219 patients with TS with postdischarge follow-up, at a mean follow-up of 4.8±3.2 years, there were 19 (8.3%) deaths, 18 of which were from non-cardiac causes. When compared with the cohort without prior CVD, postdischarge patients with TS were at increased mortality risk (HR 2.00, 95% CI 1.26 to 3.17, p=0.003), but mortality in postdischarge patients with ACS was over threefold higher (HR 3.43, 95% CI 2.97 to 3.96, p<0.0001). Conclusions: In-hospital mortality for patients diagnosed with TS and ACS was similar. However, while postdischarge survivors of TS had a long-term survival which was poorer than for a community-based cohort without known CVD, their survival was better than for postdischarge survivors of an ACS event. Late deaths in patients with TS were almost all from non-cardiac causes.
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Looi et al. (2018) conducted a cohort in Takotsubo syndrome (n=225). Takotsubo syndrome vs. Community cohort without known CVD and hospitalised ACS cohort was evaluated on Postdischarge mortality (HR 2.00, 95% CI 1.26-3.17, p=0.003). Postdischarge survivors of Takotsubo syndrome had a higher long-term mortality risk compared to a community cohort without prior CVD (HR 2.00; 95% CI 1.26-3.17; p=0.003), but better survival than ACS.
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