Younger age (≤50 years) in Takotsubo syndrome was not independently associated with in-hospital mortality compared to middle-age (OR 1.60; 95% CI 0.86-3.01; p=0.14), despite more cardiogenic shock.
Observational (n=2,098)
Yes
Are there age-related differences in clinical characteristics, hospital course, and mortality among patients with Takotsubo syndrome?
Younger patients with Takotsubo syndrome experience higher rates of cardiogenic shock and acute neurological or psychiatric disorders compared to older patients, highlighting the need for intensive care in this demographic.
Odds Ratio: 1.6 (95% CI 0.86–3.01)
Absolute Event Rate: 6.6% vs 3.6%
p-value: p=0.14
BACKGROUND Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. OBJECTIVES This study aimed to investigate age-related differences in TTS. METHODS Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. RESULTS Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. CONCLUSIONS A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.
“Since younger patients appear to have a substantially worse in-hospital course, this group presents as a particularly vulnerable patient subset in need of close monitoring and intensive care. Furthermore, studies are indicated to identify characteristics other than age that differentiate various subtypes of TTS, which may impact management and prognosis.”
Cammann et al. (2020) conducted an observational in Takotsubo syndrome (n=2,098). Younger age (≤50 years) vs. Middle-aged (51 to 74 years) was evaluated on In-hospital mortality (OR 1.60, 95% CI 0.86-3.01, p=0.14). Younger age (≤50 years) in Takotsubo syndrome was not independently associated with in-hospital mortality compared to middle-age (OR 1.60; 95% CI 0.86-3.01; p=0.14), despite more cardiogenic shock.