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1. Machine learning‐based prediction of in‐hospital death for patients with takotsubo syndrome: The InterTAK‐ML model

Author

De Filippo, Ovidio, primary, Cammann, Victoria L., additional, Pancotti, Corrado, additional, Di Vece, Davide, additional, Silverio, Angelo, additional, Schweiger, Victor, additional, Niederseer, David, additional, Szawan, Konrad A., additional, Würdinger, Michael, additional, Koleva, Iva, additional, Dusi, Veronica, additional, Bellino, Michele, additional, Vecchione, Carmine, additional, Parodi, Guido, additional, Bossone, Eduardo, additional, Gili, Sebastiano, additional, Neuhaus, Michael, additional, Franke, Jennifer, additional, Meder, Benjamin, additional, Jaguszewski, Miłosz, additional, Noutsias, Michel, additional, Knorr, Maike, additional, Jansen, Thomas, additional, Dichtl, Wolfgang, additional, von Lewinski, Dirk, additional, Burgdorf, Christof, additional, Kherad, Behrouz, additional, Tschöpe, Carsten, additional, Sarcon, Annahita, additional, Shinbane, Jerold, additional, Rajan, Lawrence, additional, Michels, Guido, additional, Pfister, Roman, additional, Cuneo, Alessandro, additional, Jacobshagen, Claudius, additional, Karakas, Mahir, additional, Koenig, Wolfgang, additional, Pott, Alexander, additional, Meyer, Philippe, additional, Roffi, Marco, additional, Banning, Adrian, additional, Wolfrum, Mathias, additional, Cuculi, Florim, additional, Kobza, Richard, additional, Fischer, Thomas A., additional, Vasankari, Tuija, additional, Airaksinen, K.E. Juhani, additional, Napp, L. Christian, additional, Dworakowski, Rafal, additional, MacCarthy, Philip, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Galiuto, Leonarda, additional, Chan, Christina, additional, Bridgman, Paul, additional, Beug, Daniel, additional, Delmas, Clément, additional, Lairez, Olivier, additional, Gilyarova, Ekaterina, additional, Shilova, Alexandra, additional, Gilyarov, Mikhail, additional, El‐Battrawy, Ibrahim, additional, Akin, Ibrahim, additional, Poledniková, Karolina, additional, Toušek, Petr, additional, Winchester, David E., additional, Massoomi, Michael, additional, Galuszka, Jan, additional, Ukena, Christian, additional, Poglajen, Gregor, additional, Carrilho‐Ferreira, Pedro, additional, Hauck, Christian, additional, Paolini, Carla, additional, Bilato, Claudio, additional, Kobayashi, Yoshio, additional, Kato, Ken, additional, Ishibashi, Iwao, additional, Himi, Toshiharu, additional, Din, Jehangir, additional, Al‐Shammari, Ali, additional, Prasad, Abhiram, additional, Rihal, Charanjit S., additional, Liu, Kan, additional, Schulze, P. Christian, additional, Bianco, Matteo, additional, Jörg, Lucas, additional, Rickli, Hans, additional, Pestana, Gonçalo, additional, Nguyen, Thanh H., additional, Böhm, Michael, additional, Maier, Lars S., additional, Pinto, Fausto J., additional, Widimský, Petr, additional, Felix, Stephan B., additional, Braun‐Dullaeus, Ruediger C., additional, Rottbauer, Wolfgang, additional, Hasenfuß, Gerd, additional, Pieske, Burkert M., additional, Schunkert, Heribert, additional, Budnik, Monika, additional, Opolski, Grzegorz, additional, Thiele, Holger, additional, Bauersachs, Johann, additional, Horowitz, John D., additional, Di Mario, Carlo, additional, Bruno, Francesco, additional, Kong, William, additional, Dalakoti, Mayank, additional, Imori, Yoichi, additional, Münzel, Thomas, additional, Crea, Filippo, additional, Lüscher, Thomas F., additional, Bax, Jeroen J., additional, Ruschitzka, Frank, additional, De Ferrari, Gaetano Maria, additional, Fariselli, Piero, additional, Ghadri, Jelena R., additional, Citro, Rodolfo, additional, D'Ascenzo, Fabrizio, additional, and Templin, Christian, additional

Published
2023
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2. Impact of Atrial Fibrillation on Outcome in Takotsubo Syndrome: Data From the International Takotsubo Registry

Author

El-Battrawy, Ibrahim, Cammann, Victoria L., Kato, Ken, Szawan, Konrad A., Di Vece, Davide, Rossi, Aurelio, Wischnewsky, Manfred, Hermes-Laufer, Julia, Gili, Sebastiano, Citro, Rodolfo, Bossone, Eduardo, Neuhaus, Michael, Franke, Jennifer, Meder, Benjamin, Jaguszewski, Milosz, Noutsias, Michel, Knorr, Maike, Heiner, Susanne, D'Ascenzo, Fabrizio, Dichtl, Wolfgang, Burgdorf, Christof, Kherad, Behrouz, Tschoepe, Carsten, Sarcon, Annahita, Shinbane, Jerold, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Koenig, Wolfgang, Pott, Alexander, Meyer, Philippe, Arroja, Jose David, Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Napp, L. Christian, Budnik, Monika, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Chan, Christina, Bridgman, Paul, Beug, Daniel, Delmas, Clement, Lairez, Olivier, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Kozel, Martin, Tousek, Petr, Winchester, David E., Galuszka, Jan, Ukena, Christian, Poglajen, Gregor, Carrilho-Ferreira, Pedro, Hauck, Christian, Paolini, Carla, Bilato, Claudio, Kobayashi, Yoshio, Prasad, Abhiram, Rihal, Charanjit S., Liu, Kan, Schulze, P. Christian, Bianco, Matteo, Joerg, Lucas, Rickli, Hans, Pestana, Goncalo, Nguyen, Thanh H., Boehm, Michael, Maier, Lars S., Pinto, Fausto J., Widimsky, Petr, Felix, Stephan B., Opolski, Grzegorz, Braun-Dullaeus, Ruediger C., Rottbauer, Wolfgang, Hasenfuss, Gerd, Pieske, Burkert M., Schunkert, Heribert, Thiele, Holger, Bauersachs, Johann, Katus, Hugo A., Horowitz, John D., Di Mario, Carlo, Muenzel, Thomas, Crea, Filippo, Bax, Jeroen J., Luescher, Thomas F., Ruschitzka, Frank, Duru, Firat, Borggrefe, Martin, Ghadri, Jelena R., Akin, Ibrahim, Templin, Christian, El-Battrawy, Ibrahim, Cammann, Victoria L., Kato, Ken, Szawan, Konrad A., Di Vece, Davide, Rossi, Aurelio, Wischnewsky, Manfred, Hermes-Laufer, Julia, Gili, Sebastiano, Citro, Rodolfo, Bossone, Eduardo, Neuhaus, Michael, Franke, Jennifer, Meder, Benjamin, Jaguszewski, Milosz, Noutsias, Michel, Knorr, Maike, Heiner, Susanne, D'Ascenzo, Fabrizio, Dichtl, Wolfgang, Burgdorf, Christof, Kherad, Behrouz, Tschoepe, Carsten, Sarcon, Annahita, Shinbane, Jerold, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Koenig, Wolfgang, Pott, Alexander, Meyer, Philippe, Arroja, Jose David, Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Napp, L. Christian, Budnik, Monika, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Chan, Christina, Bridgman, Paul, Beug, Daniel, Delmas, Clement, Lairez, Olivier, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Kozel, Martin, Tousek, Petr, Winchester, David E., Galuszka, Jan, Ukena, Christian, Poglajen, Gregor, Carrilho-Ferreira, Pedro, Hauck, Christian, Paolini, Carla, Bilato, Claudio, Kobayashi, Yoshio, Prasad, Abhiram, Rihal, Charanjit S., Liu, Kan, Schulze, P. Christian, Bianco, Matteo, Joerg, Lucas, Rickli, Hans, Pestana, Goncalo, Nguyen, Thanh H., Boehm, Michael, Maier, Lars S., Pinto, Fausto J., Widimsky, Petr, Felix, Stephan B., Opolski, Grzegorz, Braun-Dullaeus, Ruediger C., Rottbauer, Wolfgang, Hasenfuss, Gerd, Pieske, Burkert M., Schunkert, Heribert, Thiele, Holger, Bauersachs, Johann, Katus, Hugo A., Horowitz, John D., Di Mario, Carlo, Muenzel, Thomas, Crea, Filippo, Bax, Jeroen J., Luescher, Thomas F., Ruschitzka, Frank, Duru, Firat, Borggrefe, Martin, Ghadri, Jelena R., Akin, Ibrahim, and Templin, Christian

Abstract

Background Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS. Methods and Results Patients with TTS were enrolled from the International Takotsubo Registry, which is a multinational network with 26 participating centers in Europe and the United States. Patients were dichotomized according to the presence or absence of AF at the time of admission. Of 1584 patients with TTS, 112 (7.1%) had AF. The mean age was higher (P<0.001), and there were fewer women (P=0.046) in the AF than in the non-AF group. Left ventricular ejection fraction was significantly lower (P=0.001), and cardiogenic shock was more often observed (P<0.001) in the AF group. Both in-hospital (P<0.001) and long-term mortality (P<0.001) were higher in the AF group. Multivariable Cox regression analysis revealed that AF was independently associated with higher long-term mortality (hazard ratio, 2.31; 95% CI, 1.50-3.55; P<0.001). Among patients with AF on admission, 42% had no known history of AF before the acute TTS event, and such patients had comparable in-hospital and long-term outcomes compared with those with a history of AF. Conclusions In patients presenting with TTS, AF on admission is significantly associated with increased in-hospital and long-term mortality rates. Whether antiarrhythmics and/or cardioversion are beneficial in TTS with AF should thus be tested in a future trial. Registration URL: ; Unique identifier: NCT01947621.

Published
2021

3. Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry

Author

Kato, Ken, primary, Cammann, Victoria L., additional, Napp, L. Christian, additional, Szawan, Konrad A., additional, Micek, Jozef, additional, Dreiding, Sara, additional, Levinson, Rena A., additional, Petkova, Vanya, additional, Würdinger, Michael, additional, Patrascu, Alexandru, additional, Sumalinog, Rafael, additional, Gili, Sebastiano, additional, Clarenbach, Christian F., additional, Kohler, Malcolm, additional, Wischnewsky, Manfred, additional, Citro, Rodolfo, additional, Vecchione, Carmine, additional, Bossone, Eduardo, additional, Neuhaus, Michael, additional, Franke, Jennifer, additional, Meder, Benjamin, additional, Jaguszewski, Milosz, additional, Noutsias, Michel, additional, Knorr, Maike, additional, Heiner, Susanne, additional, D'Ascenzo, Fabrizio, additional, Dichtl, Wolfgang, additional, Burgdorf, Christof, additional, Kherad, Behrouz, additional, Tschöpe, Carsten, additional, Sarcon, Annahita, additional, Shinbane, Jerold, additional, Rajan, Lawrence, additional, Michels, Guido, additional, Pfister, Roman, additional, Cuneo, Alessandro, additional, Jacobshagen, Claudius, additional, Karakas, Mahir, additional, Koenig, Wolfgang, additional, Pott, Alexander, additional, Meyer, Philippe, additional, Roffi, Marco, additional, Banning, Adrian, additional, Wolfrum, Mathias, additional, Cuculi, Florim, additional, Kobza, Richard, additional, Fischer, Thomas A., additional, Vasankari, Tuija, additional, Airaksinen, K.E. Juhani, additional, Budnik, Monika, additional, Dworakowski, Rafal, additional, MacCarthy, Philip, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Galiuto, Leonarda, additional, Chan, Christina, additional, Bridgman, Paul, additional, Beug, Daniel, additional, Delmas, Clément, additional, Lairez, Olivier, additional, Gilyarova, Ekaterina, additional, Shilova, Alexandra, additional, Gilyarov, Mikhail, additional, El‐Battrawy, Ibrahim, additional, Akin, Ibrahim, additional, Kozel, Martin, additional, Tousek, Petr, additional, Winchester, David E., additional, Galuszka, Jan, additional, Ukena, Christian, additional, Poglajen, Gregor, additional, Carrilho‐Ferreira, Pedro, additional, Hauck, Christian, additional, Paolini, Carla, additional, Bilato, Claudio, additional, Sano, Masanori, additional, Ishibashi, Iwao, additional, Takahara, Masayuki, additional, Himi, Toshiharu, additional, Kobayashi, Yoshio, additional, Prasad, Abhiram, additional, Rihal, Charanjit S., additional, Liu, Kan, additional, Schulze, P. Christian, additional, Bianco, Matteo, additional, Jörg, Lucas, additional, Rickli, Hans, additional, Pestana, Gonçalo, additional, Nguyen, Thanh H., additional, Böhm, Michael, additional, Maier, Lars S., additional, Pinto, Fausto J., additional, Widimský, Petr, additional, Felix, Stephan B., additional, Opolski, Grzegorz, additional, Braun‐Dullaeus, Ruediger C., additional, Rottbauer, Wolfgang, additional, Hasenfuß, Gerd, additional, Pieske, Burkert M., additional, Schunkert, Heribert, additional, Borggrefe, Martin, additional, Thiele, Holger, additional, Bauersachs, Johann, additional, Katus, Hugo A., additional, Horowitz, John D., additional, Di Mario, Carlo, additional, Münzel, Thomas, additional, Crea, Filippo, additional, Bax, Jeroen J., additional, Lüscher, Thomas F., additional, Ruschitzka, Frank, additional, Ghadri, Jelena R., additional, and Templin, Christian, additional

Published
2021
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4. Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry

Author

D'Ascenzo, Fabrizio, Gili, Sebastiano, Bertaina, Maurizio, Iannaccone, Mario, Cammann, Victoria L., Di Vece, Davide, Kato, Ken, Saglietto, Andrea, Szawan, Konrad A., Frangieh, Antonio H., Boffini, Beatrice, Annaratone, Margherita, Sarcon, Annahita, Levinson, Rena A., Franke, Jennifer, Napp, L. Christian, Jaguszewski, Milosz, Noutsias, Michel, Muenzel, Thomas, Knorr, Maike, Heiner, Susanne, Katus, Hugo A., Burgdorf, Christof, Schunkert, Heribert, Thiele, Holger, Bauersachs, Johann, Tschoepe, Carsten, Pieske, Burkert M., Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Hasenfuss, Gerd, Karakas, Mahir, Koenig, Wolfgang, Rottbauer, Wolfgang, Said, Samir M., Braun-Dullaeus, Ruediger C., Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Opolski, Grzegorz, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Crea, Filippo, Dichtl, Wolfgang, Franz, Wolfgang M., Empen, Klaus, Felix, Stephan B., Delmas, Clement, Lairez, Olivier, El-Battrawy, Ibrahim, Akin, Ibrahim, Borggrefe, Martin, Horowitz, John D., Kozel, Martin, Tousek, Petr, Widimsky, Petr, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Biondi-Zoccai, Giuseppe, Winchester, David E., Ukena, Christian, Neuhaus, Michael, Bax, Jeroen J., Prasad, Abhiram, Di Mario, Carlo, Boehm, Michael, Gasparini, Mauro, Ruschitzka, Frank, Bossone, Eduardo, Citro, Rodolfo, Rinaldi, Mauro, De Ferrari, Gaetano Maria, Luscher, Thomas, Ghadri, Jelena R., Templin, Christian, D'Ascenzo, Fabrizio, Gili, Sebastiano, Bertaina, Maurizio, Iannaccone, Mario, Cammann, Victoria L., Di Vece, Davide, Kato, Ken, Saglietto, Andrea, Szawan, Konrad A., Frangieh, Antonio H., Boffini, Beatrice, Annaratone, Margherita, Sarcon, Annahita, Levinson, Rena A., Franke, Jennifer, Napp, L. Christian, Jaguszewski, Milosz, Noutsias, Michel, Muenzel, Thomas, Knorr, Maike, Heiner, Susanne, Katus, Hugo A., Burgdorf, Christof, Schunkert, Heribert, Thiele, Holger, Bauersachs, Johann, Tschoepe, Carsten, Pieske, Burkert M., Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Hasenfuss, Gerd, Karakas, Mahir, Koenig, Wolfgang, Rottbauer, Wolfgang, Said, Samir M., Braun-Dullaeus, Ruediger C., Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Opolski, Grzegorz, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Crea, Filippo, Dichtl, Wolfgang, Franz, Wolfgang M., Empen, Klaus, Felix, Stephan B., Delmas, Clement, Lairez, Olivier, El-Battrawy, Ibrahim, Akin, Ibrahim, Borggrefe, Martin, Horowitz, John D., Kozel, Martin, Tousek, Petr, Widimsky, Petr, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Biondi-Zoccai, Giuseppe, Winchester, David E., Ukena, Christian, Neuhaus, Michael, Bax, Jeroen J., Prasad, Abhiram, Di Mario, Carlo, Boehm, Michael, Gasparini, Mauro, Ruschitzka, Frank, Bossone, Eduardo, Citro, Rodolfo, Rinaldi, Mauro, De Ferrari, Gaetano Maria, Luscher, Thomas, Ghadri, Jelena R., and Templin, Christian

Abstract

AimsThe aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS). Methods and resultsPatients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50-3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78-1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting. ConclusionIn the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. Identifier: NCT01947621.

Published
2020

5. Impact of aspirin on takotsubo syndrome: a propensity score‐based analysis of the InterTAK Registry

Author

D'Ascenzo, Fabrizio, primary, Gili, Sebastiano, additional, Bertaina, Maurizio, additional, Iannaccone, Mario, additional, Cammann, Victoria L., additional, Di Vece, Davide, additional, Kato, Ken, additional, Saglietto, Andrea, additional, Szawan, Konrad A., additional, Frangieh, Antonio H., additional, Boffini, Beatrice, additional, Annaratone, Margherita, additional, Sarcon, Annahita, additional, Levinson, Rena A., additional, Franke, Jennifer, additional, Napp, L. Christian, additional, Jaguszewski, Milosz, additional, Noutsias, Michel, additional, Münzel, Thomas, additional, Knorr, Maike, additional, Heiner, Susanne, additional, Katus, Hugo A., additional, Burgdorf, Christof, additional, Schunkert, Heribert, additional, Thiele, Holger, additional, Bauersachs, Johann, additional, Tschöpe, Carsten, additional, Pieske, Burkert M., additional, Rajan, Lawrence, additional, Michels, Guido, additional, Pfister, Roman, additional, Cuneo, Alessandro, additional, Jacobshagen, Claudius, additional, Hasenfuß, Gerd, additional, Karakas, Mahir, additional, Koenig, Wolfgang, additional, Rottbauer, Wolfgang, additional, Said, Samir M., additional, Braun‐Dullaeus, Ruediger C., additional, Banning, Adrian, additional, Cuculi, Florim, additional, Kobza, Richard, additional, Fischer, Thomas A., additional, Vasankari, Tuija, additional, Airaksinen, K.E. Juhani, additional, Opolski, Grzegorz, additional, Dworakowski, Rafal, additional, MacCarthy, Philip, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Galiuto, Leonarda, additional, Crea, Filippo, additional, Dichtl, Wolfgang, additional, Franz, Wolfgang M., additional, Empen, Klaus, additional, Felix, Stephan B., additional, Delmas, Clément, additional, Lairez, Olivier, additional, El‐Battrawy, Ibrahim, additional, Akin, Ibrahim, additional, Borggrefe, Martin, additional, Horowitz, John D., additional, Kozel, Martin, additional, Tousek, Petr, additional, Widimský, Petr, additional, Gilyarova, Ekaterina, additional, Shilova, Alexandra, additional, Gilyarov, Mikhail, additional, Biondi‐Zoccai, Giuseppe, additional, Winchester, David E., additional, Ukena, Christian, additional, Neuhaus, Michael, additional, Bax, Jeroen J., additional, Prasad, Abhiram, additional, Di Mario, Carlo, additional, Böhm, Michael, additional, Gasparini, Mauro, additional, Ruschitzka, Frank, additional, Bossone, Eduardo, additional, Citro, Rodolfo, additional, Rinaldi, Mauro, additional, De Ferrari, Gaetano Maria, additional, Lüscher, Thomas, additional, Ghadri, Jelena R., additional, and Templin, Christian, additional

Published
2019
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6. Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry

Author

Cammann, Victoria L., Sarcon, Annahita, Ding, Katharina J., Seifert, Burkhardt, Kato, Ken, Di Vece, Davide, Szawan, Konrad A., Gili, Sebastiano, Jurisic, Stjepan, Bacchi, Beatrice, Micek, Jozef, Frangieh, Antonio H., Napp, L. Christian, Jaguszewski, Milosz, Bossone, Eduardo, Citro, Rodolfo, D'Ascenzo, Fabrizio, Franke, Jennifer, Noutsias, Michel, Knorr, Maike, Heiner, Susanne, Burgdorf, Christof, Koenig, Wolfgang, Thiele, Holger, Tschope, Carsten, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Dworakowski, Rafal, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Dichtl, Wolfgang, Delmas, Clement, Lairez, Olivier, Horowitz, John D., Kozel, Martin, Widimsky, Petr, Tousek, Petr, Winchester, David E., Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, El-Battrawy, Ibrahim, Akin, Ibrahim, Ukena, Christian, Bauersachs, Johann, Pieske, Burkert M., Hasenfuss, Gerd, Rottbauer, Wolfgang, Braun-Dullaeus, Ruediger C., Opolski, Grzegorz, MacCarthy, Philip, Felix, Stephan B., Borggrefe, Martin, Di Mario, Carlo, Crea, Filippo, Katus, Hugo A., Schunkert, Heribert, Munzel, Thomas, Bohm, Michael, Bax, Jeroen J., Prasad, Abhiram, Shinbane, Jerold, Luscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., Templin, Christian, Cammann, Victoria L., Sarcon, Annahita, Ding, Katharina J., Seifert, Burkhardt, Kato, Ken, Di Vece, Davide, Szawan, Konrad A., Gili, Sebastiano, Jurisic, Stjepan, Bacchi, Beatrice, Micek, Jozef, Frangieh, Antonio H., Napp, L. Christian, Jaguszewski, Milosz, Bossone, Eduardo, Citro, Rodolfo, D'Ascenzo, Fabrizio, Franke, Jennifer, Noutsias, Michel, Knorr, Maike, Heiner, Susanne, Burgdorf, Christof, Koenig, Wolfgang, Thiele, Holger, Tschope, Carsten, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Dworakowski, Rafal, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Dichtl, Wolfgang, Delmas, Clement, Lairez, Olivier, Horowitz, John D., Kozel, Martin, Widimsky, Petr, Tousek, Petr, Winchester, David E., Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, El-Battrawy, Ibrahim, Akin, Ibrahim, Ukena, Christian, Bauersachs, Johann, Pieske, Burkert M., Hasenfuss, Gerd, Rottbauer, Wolfgang, Braun-Dullaeus, Ruediger C., Opolski, Grzegorz, MacCarthy, Philip, Felix, Stephan B., Borggrefe, Martin, Di Mario, Carlo, Crea, Filippo, Katus, Hugo A., Schunkert, Heribert, Munzel, Thomas, Bohm, Michael, Bax, Jeroen J., Prasad, Abhiram, Shinbane, Jerold, Luscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., and Templin, Christian

Abstract

Background-Clinical characteristics and outcomes of takotsubo syndrome (US) patients with malignancy have not been fully elucidated. This study sought to explore differences in clinical characteristics and to investigate short- and long-term outcomes in TTS patients with or without malignancy. Methods and Results-ITS patients were enrolled from the International Takotsubo Registry. The TTS cohort was divided into patients with and without malignancy to investigate differences in clinical characteristics and to assess short- and long-term mortality. A subanalysis was performed comparing long-term mortality between a subset of TTS patients with or without malignancy and acute coronary syndrome (ACS) patients with or without malignancy. Malignancy was observed in 16.6% of 1604 TTS patients. Patients with malignancy were older and more likely to have physical triggers, but less likely to have emotional triggers compared with those without malignancy. Long-term mortality was higher in patients with malignancy (P<0.001), while short-term outcome was comparable (P=0.17). In a subanalysis, long-term mortality was comparable between TTS patients with malignancies and ACS patients with malignancies (P=0.13). Malignancy emerged as an independent predictor of long-term mortality. Conclusions-A substantial number of TTS patients show an association with malignancy. History of malignancy might increase the risk for TTS, and therefore, appropriate screening for malignancy should be considered in these patients.

Published
2019

7. Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome: Results From the International Takotsubo Registry

Author

Jurisic, Stjepan, Gili, Sebastiano, Cammann, Victoria L., Kato, Ken, Szawan, Konrad A., D'Ascenzo, Fabrizio, Jaguszewski, Milosz, Bossone, Eduardo, Citro, Rodolfo, Sarcon, Annahita, Napp, L. Christian, Franke, Jennifer, Noutsias, Michel, Knorr, Maike, Heiner, Susanne, Burgdorf, Christof, Koenig, Wolfgang, Pott, Alexander, Kherad, Behrouz, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Meyer, Philippe, Arroja, Jose David, Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Dworakowski, Rafal, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Dichtl, Wolfgang, Chan, Christina, Bridgman, Paul, Beug, Daniel, Delmas, Clement, Lairez, Olivier, Kozel, Martin, Tousek, Petr, Winchester, David E., Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, El-Battrawy, Ibrahim, Akin, Ibrahim, Galuszka, Jan, Ukena, Christian, Poglajen, Gregor, Paolini, Carla, Bilato, Claudio, Carrilho-Ferreira, Pedro, Pinto, Fausto J., Opolski, Grzegorz, MacCarthy, Philip, Kobayashi, Yoshio, Prasad, Abhiram, Rihal, Charanjit S., Widimsky, Petr, Horowitz, John D., Di Mario, Carlo, Crea, Filippo, Tschope, Carsten, Pieske, Burkert M., Hasenfuss, Gerd, Rottbauer, Wolfgang, Braun-Dullaeus, Ruediger C., Felix, Stephan B., Borggrefe, Martin, Thiele, Holger, Bauersachs, Johann, Katus, Hugo A., Schunkert, Heribert, Muenzel, Thomas, Bohm, Michael, Bax, Jeroen J., Luscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., Templin, Christian, Jurisic, Stjepan, Gili, Sebastiano, Cammann, Victoria L., Kato, Ken, Szawan, Konrad A., D'Ascenzo, Fabrizio, Jaguszewski, Milosz, Bossone, Eduardo, Citro, Rodolfo, Sarcon, Annahita, Napp, L. Christian, Franke, Jennifer, Noutsias, Michel, Knorr, Maike, Heiner, Susanne, Burgdorf, Christof, Koenig, Wolfgang, Pott, Alexander, Kherad, Behrouz, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Meyer, Philippe, Arroja, Jose David, Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K. E. Juhani, Dworakowski, Rafal, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Dichtl, Wolfgang, Chan, Christina, Bridgman, Paul, Beug, Daniel, Delmas, Clement, Lairez, Olivier, Kozel, Martin, Tousek, Petr, Winchester, David E., Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, El-Battrawy, Ibrahim, Akin, Ibrahim, Galuszka, Jan, Ukena, Christian, Poglajen, Gregor, Paolini, Carla, Bilato, Claudio, Carrilho-Ferreira, Pedro, Pinto, Fausto J., Opolski, Grzegorz, MacCarthy, Philip, Kobayashi, Yoshio, Prasad, Abhiram, Rihal, Charanjit S., Widimsky, Petr, Horowitz, John D., Di Mario, Carlo, Crea, Filippo, Tschope, Carsten, Pieske, Burkert M., Hasenfuss, Gerd, Rottbauer, Wolfgang, Braun-Dullaeus, Ruediger C., Felix, Stephan B., Borggrefe, Martin, Thiele, Holger, Bauersachs, Johann, Katus, Hugo A., Schunkert, Heribert, Muenzel, Thomas, Bohm, Michael, Bax, Jeroen J., Luscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., and Templin, Christian

Abstract

Background-Left ventricular (LV) recovery in takotsubo syndrome (TTS) occurs over a wide-ranging interval, varying from hours to weeks. We sought to investigate the clinical predictors and prognostic impact of recovery time for TTS patients. Methods and Results-TTS patients from the International Takotsubo Registry were included in this study. Cut-off for early LV recovery was determined to be 10 days after the acute event. Multivariable logistic regression was used to assess factors associated with the absence of early recovery. In-hospital outcomes and 1-year mortality were compared for patients with versus without early recovery. We analyzed 406 patients with comprehensive and serial imaging data regarding time to recovery. Of these, 191 (47.0%) had early LV recovery and 215 (53.0%) demonstrated late LV improvement. Patients without early recovery were more often male (12.6% versus 5.2%; P=0.011) and presented more frequently with typical TTS (76.3% versus 67.0%, P=0.040). Cardiac and inflammatory markers were higher in patients without early recovery than in those with early recovery. Patients without early recovery showed unfavorable 1-year outcome compared with patients with early recovery (P=0.003). On multiple logistic regression, male sex, LV ejection fraction <45%, and acute neurologic disorders were associated with the absence of early recovery. Conclusions-TTS patients without early LV recovery have different clinical characteristics and less favorable 1-year outcome compared with patients with early recovery. The factors associated with the absence of early recovery included male sex, reduced LV ejection fraction, and acute neurologic events.

Published
2019

8. Prediction of long‐term patient outcome after contemporary left main stenting using the SYNTAX and SYNTAX II scores: A comparative analysis from the FAIL‐II multicenter registry (failure in left main study with 2nd generation stents‐Cardiogroup III study)

Author

Cerrato, Enrico, primary, Barbero, Umberto, additional, Quadri, Giorgio, additional, Ryan, Nicola, additional, D'Ascenzo, Fabrizio, additional, Tomassini, Francesco, additional, Quirós, Alicia, additional, Bellucca, Simone, additional, Conrotto, Federico, additional, Ugo, Fabrizio, additional, Kawamoto, Hiroyoshi, additional, Rolfo, Cristina, additional, Pavani, Marco, additional, Mejia‐Renteria, Hernan, additional, Gili, Sebastiano, additional, Iannaccone, Mario, additional, Debenedictis, Michele, additional, Baldassarre, Doronzo, additional, Biondi‐Zoccai, Giuseppe, additional, Colombo, Antonio, additional, Varbella, Ferdinando, additional, and Escaned, Javier, additional

Published
2019
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9. Prediction of short‐ and long‐term mortality in takotsubo syndrome: the InterTAK Prognostic Score

Author

Wischnewsky, Manfred B., primary, Candreva, Alessandro, additional, Bacchi, Beatrice, additional, Cammann, Victoria L., additional, Kato, Ken, additional, Szawan, Konrad A., additional, Gili, Sebastiano, additional, D'Ascenzo, Fabrizio, additional, Dichtl, Wolfgang, additional, Citro, Rodolfo, additional, Bossone, Eduardo, additional, Neuhaus, Michael, additional, Franke, Jennifer, additional, Sorici‐Barb, Ioana, additional, Jaguszewski, Milosz, additional, Noutsias, Michel, additional, Knorr, Maike, additional, Heiner, Susanne, additional, Burgdorf, Christof, additional, Kherad, Behrouz, additional, Tschöpe, Carsten, additional, Sarcon, Annahita, additional, Shinbane, Jerold, additional, Rajan, Lawrence, additional, Michels, Guido, additional, Pfister, Roman, additional, Cuneo, Alessandro, additional, Jacobshagen, Claudius, additional, Karakas, Mahir, additional, Koenig, Wolfgang, additional, Pott, Alexander, additional, Meyer, Philippe, additional, Arroja, Jose David, additional, Banning, Adrian, additional, Cuculi, Florim, additional, Kobza, Richard, additional, Fischer, Thomas A., additional, Vasankari, Tuija, additional, Airaksinen, K.E. Juhani, additional, Napp, L. Christian, additional, Budnik, Monika, additional, Dworakowski, Rafal, additional, MacCarthy, Philip, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Galiuto, Leonarda, additional, Chan, Christina, additional, Bridgman, Paul, additional, Beug, Daniel, additional, Delmas, Clément, additional, Lairez, Olivier, additional, El‐Battrawy, Ibrahim, additional, Akin, Ibrahim, additional, Gilyarova, Ekaterina, additional, Shilova, Alexandra, additional, Gilyarov, Mikhail, additional, Kozel, Martin, additional, Tousek, Petr, additional, Winchester, David E., additional, Galuszka, Jan, additional, Ukena, Christian, additional, Poglajen, Gregor, additional, Carrilho‐Ferreira, Pedro, additional, Hauck, Christian, additional, Paolini, Carla, additional, Bilato, Claudio, additional, Prasad, Abhiram, additional, Rihal, Charanjit S., additional, Liu, Kan, additional, Schulze, P. Christian, additional, Bianco, Matteo, additional, Jörg, Lucas, additional, Rickli, Hans, additional, Nguyen, Thanh H., additional, Kobayashi, Yoshio, additional, Böhm, Michael, additional, Maier, Lars S., additional, Pinto, Fausto J., additional, Widimský, Petr, additional, Borggrefe, Martin, additional, Felix, Stephan B., additional, Opolski, Grzegorz, additional, Braun‐Dullaeus, Ruediger C., additional, Rottbauer, Wolfgang, additional, Hasenfuß, Gerd, additional, Pieske, Burkert M., additional, Schunkert, Heribert, additional, Thiele, Holger, additional, Bauersachs, Johann, additional, Katus, Hugo A., additional, Horowitz, John, additional, Di Mario, Carlo, additional, Münzel, Thomas, additional, Crea, Filippo, additional, Bax, Jeroen J., additional, Lüscher, Thomas F., additional, Ruschitzka, Frank, additional, Ghadri, Jelena R., additional, and Templin, Christian, additional

Published
2019
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10. Self‐expandable sirolimus‐eluting stents compared to second‐generation drug‐eluting stents for the treatment of the left main: A propensity score analysis from the SPARTA and the FAILS‐2 registries

Author

Montefusco, Antonio, primary, D'Ascenzo, Fabrizio, additional, Gili, Sebastiano, additional, Smolka, Grzegorz, additional, Chieffo, Alaide, additional, Baumbach, Andreas, additional, Escaned, Javier, additional, Sganzerla, Paolo, additional, Tomassini, Francesco, additional, Secco, Gioel Gabrio, additional, Ugo, Fabrizio, additional, Tamburino, Corrado, additional, Nicolino, Annamaria, additional, Mancone, Massimo, additional, Poli, Arnaldo, additional, Yew, Kuan‐Leong, additional, Cirillo, Plinio, additional, Wanha, Wojciech, additional, Pastormerlo, Luigi Emilio, additional, di Summa, Roberto, additional, Sardella, Gennaro, additional, Colombo, Antonio, additional, Gaita, Fiorenzo, additional, and Cortese, Bernardo, additional

Published
2018
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11. Clinical impact of optical coherence tomography findings on culprit plaque in acute coronary syndrome: The OCT‐FORMIDABLE study registry

Author

Iannaccone, Mario, primary, Souteyrand, Geraud, additional, Niccoli, Giampaolo, additional, Mancone, Massimo, additional, Sardella, Gennaro, additional, Tamburino, Corrado, additional, Templin, Christian, additional, Gili, Sebastiano, additional, Boccuzzi, Giacomo G, additional, and D'Ascenzo, Fabrizio, additional

Published
2018
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13. Cardiac troponin elevation and mortality in takotsubo syndrome: New insights from the international takotsubo registry.

Author

Stähli BE, Schindler M, Schweiger V, Cammann VL, Szawan KA, Niederseer D, Würdinger M, Schönberger A, Schönberger M, Koleva I, Mercier JC, Petkova V, Mayer S, Citro R, Vecchione C, Bossone E, Gili S, Neuhaus M, Franke J, Meder B, Jaguszewski M, Noutsias M, Knorr M, Jansen T, D'Ascenzo F, Dichtl W, von Lewinski D, Burgdorf C, Kherad B, Tschöpe C, Sarcon A, Shinbane J, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Koenig W, Pott A, Meyer P, Roffi M, Banning A, Wolfrum M, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Napp LC, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Chan C, Bridgman P, Beug D, Delmas C, Lairez O, Gilyarova E, Shilova A, Gilyarov M, El-Battrawy I, Akin I, Poledniková K, Toušek P, Winchester DE, Massoomi M, Galuszka J, Ukena C, Poglajen G, Carrilho-Ferreira P, Hauck C, Paolini C, Bilato C, Kobayashi Y, Kato K, Ishibashi I, Himi T, Din J, Al-Shammari A, Prasad A, Rihal CS, Liu K, Schulze PC, Bianco M, Jörg L, Rickli H, Pestana G, Nguyen TH, Böhm M, Maier LS, Pinto FJ, Widimský P, Felix SB, Braun-Dullaeus RC, Rottbauer W, Hasenfuß G, Pieske BM, Schunkert H, Budnik M, Opolski G, Thiele H, Bauersachs J, Horowitz JD, Di Mario C, Kong W, Dalakoti M, Imori Y, Liberale L, Montecucco F, Münzel T, Crea F, Lüscher TF, Bax JJ, Ruschitzka F, Ghadri JR, Di Vece D, and Templin C

Subjects
Humans, Female, Male, Aged, Middle Aged, Troponin I blood, Troponin blood, Troponin metabolism, Aged, 80 and over, Takotsubo Cardiomyopathy blood, Takotsubo Cardiomyopathy mortality, Registries, Troponin T blood
Abstract

Background: The clinical relevance of cardiac troponin (cTn) elevation in takotsubo syndrome (TTS) remains uncertain. The present study sought to investigate the role of cardiac troponin (cTn) elevations in mortality prediction of patients with Takotsubo syndrome (TTS)., Methods: Patients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to February 2020 with available data on peak cTn levels were included in the analysis. Peak cTn levels during the index hospitalization were used to define clinically relevant myocardial injury. The threshold at which clinically relevant myocardial injury drives mortality at 1 year was identified using restricted cubic spline analysis., Results: Out of 2'938 patients, 222 (7.6%) patients died during 1-year follow-up. A more than 28.8-fold increase of cTn above the upper reference limit was identified as threshold for clinically relevant myocardial injury. The presence of clinically relevant myocardial injury was significantly associated with an increased risk of mortality at 5 years (adjusted HR 1.58, 95% CI 1.18-2.12, p =.002). Clinically relevant myocardial injury was related to an increased 5-year mortality risk in patients with apical TTS (adjusted HR 1.57, 95% CI 1.21-2.03, p =.001), in presence of physical stressors (adjusted HR 1.60, 95% CI 1.22-2.11, p =.001), and in absence of emotional stressors (adjusted HR 1.49, 95% CI, 1.17-1.89, p =.001)., Conclusion: This study for the first time determined a troponin threshold for the identification of TTS patients at excess risk of mortality. These findings advance risk stratification in TTS and assist in identifying patients in need for close monitoring and follow-up., (© 2024 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)

Published
2024
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14. Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry.

Author

D'Ascenzo F, Gili S, Bertaina M, Iannaccone M, Cammann VL, Di Vece D, Kato K, Saglietto A, Szawan KA, Frangieh AH, Boffini B, Annaratone M, Sarcon A, Levinson RA, Franke J, Napp LC, Jaguszewski M, Noutsias M, Münzel T, Knorr M, Heiner S, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuß G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Franz WM, Empen K, Felix SB, Delmas C, Lairez O, El-Battrawy I, Akin I, Borggrefe M, Horowitz JD, Kozel M, Tousek P, Widimský P, Gilyarova E, Shilova A, Gilyarov M, Biondi-Zoccai G, Winchester DE, Ukena C, Neuhaus M, Bax JJ, Prasad A, Di Mario C, Böhm M, Gasparini M, Ruschitzka F, Bossone E, Citro R, Rinaldi M, De Ferrari GM, Lüscher T, Ghadri JR, and Templin C

Subjects
Heart Failure, Humans, Ischemic Attack, Transient, Myocardial Infarction, Platelet Aggregation Inhibitors therapeutic use, Propensity Score, Recurrence, Registries, Stroke, Treatment Outcome, Aspirin therapeutic use, Takotsubo Cardiomyopathy drug therapy, Takotsubo Cardiomyopathy epidemiology
Abstract

Aims: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS)., Methods and Results: Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50-3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78-1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting., Conclusion: In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621., (© 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology.)

Published
2020
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15. Interaction of systolic blood pressure and resting heart rate with clinical outcomes in takotsubo syndrome: insights from the International Takotsubo Registry.

Author

Böhm M, Cammann VL, Ghadri JR, Ukena C, Gili S, Di Vece D, Kato K, Ding KJ, Szawan KA, Micek J, Jurisic S, D'Ascenzo F, Frangieh AH, Rechsteiner D, Seifert B, Ruschitzka F, Lüscher T, and Templin C

Subjects
Aged, Cause of Death trends, Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prognosis, Prospective Studies, Retrospective Studies, Survival Rate trends, Systole, Takotsubo Cardiomyopathy epidemiology, United States epidemiology, Blood Pressure physiology, Heart Rate physiology, Registries, Rest physiology, Takotsubo Cardiomyopathy physiopathology
Abstract

Aims: The present study aimed to determine the prognostic impact of resting heart rate (HR) and systolic blood pressure (SBP) in takotsubo syndrome (TTS)., Methods and Results: Patients from the International Takotsubo Registry with complete data on HR and SBP were enrolled. We analysed all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) in tertiles of HR (<77 b.p.m., 77-94 b.p.m., >94 b.p.m.) and SBP (<119 mmHg, 119-140 mmHg, >140 mmHg). In addition, linear splines with interactions between HR and SBP were analysed. The risk of all-cause mortality was higher in the second HR tertile (1.89, 1.15-3.10; P = 0.012) and the third HR tertile (3.01, 1.90-4.79; P < 0.001) than in the first tertile. Similar effects were observed for MACCE. Low SBP was related to an increased risk of all-cause mortality (P < 0.001) and MACCE (P = 0.002). In a multivariable analysis of all-cause mortality, at HR >70 b.p.m., every 1 b.p.m. increase in HR was associated with a 1.7% increase (P < 0.001), and every 1 mmHg increase in SBP up to 130 mmHg was associated with a 2% risk reduction (P < 0.001). The risk of all-cause mortality thus was particularly elevated when low SBP occurred together with high HR., Conclusions: High HR and low SBP are associated with an increased risk of all-cause mortality in TTS. HR reduction might be worthy of being investigated as a therapeutic strategy for this condition and high HR and low SBP can be used to evaluate risk in this acute presentation of TTS., Clinical Trial Registration: ClinicalTrials.gov NCT01947621., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)

Published
2018
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