Clinical characteristics and outcomes of patients with takotsubo syndrome versus spontaneous coronary artery dissection

Cammann, Victoria L.; Sarcon, Annahita; Szawan, Konrad A.; Würdinger, Michael; Azam, Saif; Shinbane, Jerold S.; Seifert, Burkhardt; Ghadri, Jelena R.; Saw, Jacqueline; Templin, Christian

doi:10.5603/cj.a2021.0065

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…A major difference between these two clinical entities is the large age gap that explain how differently these syndromes are perceived in real-world clinical settings. The age distribution in our SCAD and TTS groups is comparable to that found in previous registries [11,12,17,18]. Hypertension, dyslipidemia, and diabetes were more common in the TTS group.…”

Section: Discussionsupporting

confidence: 87%

“…This subset of TTS patients has been previously associated with a worse prognosis as compared to primary forms of TTS and this may also explain the adverse in-hospital and long-term prognosis of our TTS patients [27,28]. In line with some previous studies, emotional stress triggers were more frequently seen among SCAD patients than in TTS (also known as 'stress cardiomyopathy') [8,12]. Besides and importantly, SCAD group had a higher prevalence of depression disorder with no difference in previous history of anxiety disorder.…”

Section: Discussionsupporting

confidence: 82%

“…In spite of the aforementioned spontaneous healing of the affected vessel in SCAD and the wall motion abnormalities recovery in TTS, both clinical entities present substantial morbidity and mortality during in-hospital and long-term follow-up [8][9][10][11][12]. However, scarce information is available directly comparing the long-term follow-up of these two clinical entities.…”

Section: Introductionmentioning

confidence: 99%

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Non-atherosclerotic acute cardiac syndromes: spontaneous coronary artery dissection and Takotsubo syndrome. Comparison of long-term clinical outcomes

Salamanca,

García-Guimaraes,

Sabaté

et al. 2023

Coronary Artery Disease

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Background Spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS) constitute two common causes of nonatherosclerotic acute cardiac syndrome particularly frequent in women. Currently, there is no information comparing long-term clinical outcomes in unselected patients with these conditions. Methods We compared the baseline characteristics, in-hospital outcomes, and the 12-month and long-term clinical outcomes of two large prospective registries on SCAD and TTS. Results A total of 289 SCAD and 150 TTS patients were included; 89% were women. TTS patients were older with a higher prevalence of cardiovascular risk factors. Precipitating triggers were more frequent in TTS patients, while emotional triggers and depressive disorders were more common in the SCAD group. Left ventricular ejection fraction was lower in TTS patients, but SCAD patients showed higher cardiac biomarkers. In-hospital events (43.3% vs. 5.2%, P<0.01) occurred more frequently in TTS patients. TTS patients also presented more frequent major adverse events at 12-month (14.7% vs. 7.1%, HR 5.3, 95% CI: 2.4–11.7, P<0.01) and long-term (median 36 vs. 31 months, P=0.41) follow-up (25.8% vs. 9.6%, HR 4.5, 95% CI: 2.5–8.2, P<0.01). Atrial fibrillation was also more frequent in TTS patients. Moreover, TTS patients presented a higher 12-month and long-term mortality (5.6% vs. 0.7%, P=0.01; and 12.6% vs. 0.7%, P<0.01) mainly driven by noncardiovascular deaths. Conclusion Compared to SCAD, TTS patients are older and present more cardiovascular risk factors but less frequent depressive disorder or emotional triggers. TTS patients have a worse in-hospital, mid-term, and long-term prognosis with higher noncardiac mortality than SCAD patients.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Non-atherosclerotic acute cardiac syndromes: spontaneous coronary artery dissection and Takotsubo syndrome. Comparison of long-term clinical outcomes

Salamanca,

García-Guimaraes,

Sabaté

et al. 2023

Coronary Artery Disease

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“…Patients with TS have worse in-hospital complications and outcomes including a higher risk of mortality during the index admission compared with SCAD [43]. Cammann et al [46] reported that left ventricular ejection was more impaired in TS compared to SCAD. In addition, 30-day mortality was significantly higher in TS patients in the same study.…”

Section: Association Of Scad and Takotsubo Syndromementioning

confidence: 99%

Recurrent Spontaneous Coronary Artery Dissection: Association with Takotsubo Syndrome and Fibromuscular Dysplasia; Comprehensive Review

Y‐Hassan¹,

Abdula²,

Böhm³

2022

Rev. Cardiovasc. Med.

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Spontaneous coronary artery dissection (SCAD) is a non-traumatic, non-iatrogenic, and non-atherosclerotic separation or dissection of the coronary arterial wall by the formation of an intramural hematoma causing a false lumen leading to compression of the true lumen with a varying degree of coronary blood flow obstruction. One of the important and frequent complications of the disease is the inhospital and long-term SCAD recurrence. SCAD associated with takotsubo syndrome (TS) has been described in case reports, series of cases and in some studies. Some investigators believe that the association of SCAD and TS is a misdiagnosis. The association of SCAD and fibromuscular dysplasia (FMD) has received major attention during the last 10 years. In this report, the short and long-term SCAD recurrence, SCAD association with TS and FMD are reviewed and demonstrated with illustrative images.

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“…It was with interest that the present authors read an article by Victoria L. Cammann et al [ 1 ], who compared clinical features and outcomes in patients with Takotsubo syndrome (TTS) and spontaneous coronary artery dissection (SCAD). The study compared the clinical characteristics and outcomes of 2098 TTS patients from the International Takotsubo Registry to 750 SCAD patients from the Canadian Spontaneous Coronary Artery Dissection Cohort Study.…”

mentioning

confidence: 99%

Endothelial dysfunction: Can it differentiate Takotsubo syndrome from spontaneous coronary artery dissection?

Skrobucha,

Borowiak,

Szarpak

et al. 2023

Cardiol J.

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Clinical characteristics and outcomes of patients with takotsubo syndrome versus spontaneous coronary artery dissection

Abstract: Clinical characteristics and outcomes of patients with takotsubo syndrome versus spontaneous coronary artery dissectionVictoria L. Cammann et al., Takotsubo syndrome vs. spontaneous coronary artery dissection

Cited by 7 publications

References 23 publications

Non-atherosclerotic acute cardiac syndromes: spontaneous coronary artery dissection and Takotsubo syndrome. Comparison of long-term clinical outcomes

Non-atherosclerotic acute cardiac syndromes: spontaneous coronary artery dissection and Takotsubo syndrome. Comparison of long-term clinical outcomes

Recurrent Spontaneous Coronary Artery Dissection: Association with Takotsubo Syndrome and Fibromuscular Dysplasia; Comprehensive Review

Endothelial dysfunction: Can it differentiate Takotsubo syndrome from spontaneous coronary artery dissection?

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