Cardiac arrhythmias and In-hospital mortality amongst patients with takotsubo cardiomyopathy: A retrospective study in an Italian population

Abstract

Highlights: Takotsubo cardiomyopathy was more common in women and the mortality rate was 2.2%. Ventricular arrhythmias were the strongest predictor of mortality. Age was associated with increased mortality in women with takotsubo cardiomyopathy.

Prognostic factors of Takotsubo cardiomyopathy: a systematic review

“…In a subanalysis of sex in the same study, age predicted in-hospital mortality in female patients (OR 1.06, 95% CI 1.04-1.08) but did not have the same predictive value among male patients (P = 0.08). 28 Other studies suggest that age is not associated with shortterm mortality in TCM patients (Table 2). 18,19,23,27,38,63,69,70 After a multivariable logistic regression analysis, Cammann et al found no significant difference among different age groups in in-hospital mortality (age 51-74 years old as reference, ≤50 years old, P = 0.14; ≥75 years old, P = 0.75) or 60 day mortality (P = 0.16).…”

“…16 Despite female sex being a strong risk factor for TCM, most of the studies we identified suggest that it is associated with favourable short-term outcomes in TCM (Table 1). Some studies have found that male patients have poorer short-term outcomes, such as higher rates of in-hospital mortality 19,[23][24][25][26][27][28][29][30][31] and complications. 18,20,32 One retrospective study of 14 639 patients found that female patients had a lower rate of in-hospital mortality [odds ratio (OR) 0.521, 95% confidence interval (CI) 0.389-0.699].…”

“…Some studies have associated older age with a higher short‐term mortality rate. 22 , 24 , 28 , 30 , 33 , 34 , 35 , 36 , 37 , 44 , 64 , 65 , 66 , 67 , 68 For example, in one prospective study with 19 966 TCM patients (8068 patients with a primary diagnosis of TCM and 11 898 with a secondary diagnosis), patients were grouped by age into three categories: 65–74, 75–84, and ≥85 years. The patients 85 years or older had the highest overall in‐hospital mortality rate (primary TCM: 2.6% in patients aged more than 85 years vs. 1.5% in patients aged 75 to 84 vs. 0.74% in patients aged 65 to 74, P < 0.05; secondary TCM: 4.5% vs. 3.3% vs. 2.2%, P < 0.05) and the highest 30 day mortality rate (primary TCM, 4.9% vs. 2.7% vs. 1.7%, P < 0.05; secondary TCM 7.7% vs. 5.1% vs. 3.6%, P < 0.05).…”

High-degree atrioventricular block. An unusual presentation of Takotsubo cardiomyopathy: a case report

“…Very few cases describe the normalization of AV conduction related to TCM [7][8][9], and this is the first case that reports it just a few hours after admission. Recent data suggest that advanced atrioventricular block is not associated with worse in hospital outcomes unlike what occurs with ventricular arrhythmias [10]. Two years after the admission, the patient remains asymptomatic with a first-degree AV block on the electrocardiogram.…”

Long-term outcomes in patients with Takotsubo syndrome

“…The Italian group recently demonstrated that male sex and ventricular arrhythmias were associated with in-hospital mortality in patients hospitalized for Takotsubo syndrome [3] . Data of arrhythmias would further strengthen the implication of their study.…”