Clinical Characteristics and Outcomes of Patients With Takotsubo Syndrome

Can J Cardiol. 2021 Aug;37(8):1191-1197. doi: 10.1016/j.cjca.2021.01.014. Epub 2021 Jan 20.

Abstract

Background: Characteristics and outcomes of patients with takotsubo syndrome remain to be defined. The goal of this study was to report the characteristics and long-term outcomes of patients presenting with takotsubo syndrome compared with other patients presenting with acute myocardial infarction (AMI) in a community-based population.

Methods: This retrospective population-based study included patients hospitalised for AMI from 2006 to 2016. Those patients with takotsubo syndrome were compared with the patients with AMI. The primary outcome was all-cause mortality. Matching was performed to assemble a cohort of patients with similar baseline characteristics.

Results: Among 26,015 patients hospitalised with an initial diagnosis of AMI, 530 (2.0%) were diagnosed with takotsubo syndrome. Patients with takotsubo syndrome were older (68.3 ± 11.3 vs 65.6 ± 12.2 years) and more likely to be women (93.4% vs 30.7%). Concomitant hypothyroidism, rheumatologic disorders, and lung disease were more prevalent in the takotsubo syndrome group, whereas diabetes and hyperlipidemia were less prevalent. Mortality was lower in the takotsubo syndrome group (1-year mortality 4.0% vs 8.9%; P < 0.001). The 530 patients with takotsubo syndrome were matched with 1,315 AMI patients with similar baseline characteristics. At a follow-up of 5.4 ± 3.3 years, patients with takotsubo syndrome had a lower risk for all-cause death than other patients who presented with AMI (hazard ratio 0.59, 95% CI 0.47-0.76).

Conclusions: Among patients presenting with AMI, patients with takotsubo syndrome were older and more likely to be women. Patients with takotsubo syndrome had better long-term outcomes compared with matched AMI patients.

MeSH terms

  • Age Distribution
  • Aged
  • California / epidemiology
  • Female
  • Hospitalization
  • Humans
  • Hypothyroidism / epidemiology
  • Lung Diseases / epidemiology
  • Male
  • Matched-Pair Analysis
  • Myocardial Infarction / epidemiology
  • Retrospective Studies
  • Rheumatic Diseases / epidemiology
  • Sex Distribution
  • Takotsubo Cardiomyopathy / epidemiology*