In-hospital Takotsubo syndrome versus in-hospital acute myocardial infarction among patients admitted for non-cardiac diseases: a nationwide inpatient database study

Isogai, Toshiaki; Matsui, Hiroki; Tanaka, Hiroyuki; Fushimi, Kiyohide; Yasunaga, Hideo

doi:10.1007/s00380-019-01382-5

Cited by 4 publications

(6 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Simply adjusting for sex in multivariable statistical models may not be enough if the sex disparity in the comparator groups is as large as it tends to be between STEMI and TS. 20,28,29 Nevertheless, the main observation in our study that ventricular arrhythmias are less common after TS than STEMI is consistent with previous studies. 28,30 These arrhythmias included sustained VT and VF and were not restricted to short bursts of non-sustained VT. Our results confirm that, even though the extent of LV akinesia is at least as extensive in TS as in STEMI, cardiac electrophysiology appears to remain more stable in TS than STEMI.…”

Section: Discussionsupporting

confidence: 93%

“…Because there are important differences between women and men in the pathophysiology of STEMI, and the propensity for arrhythmias or poor outcome after STEMI, 18,21–27 it is difficult to know whether differences observed in previous studies between predominantly male patients with STEMI and predominantly female patients with TS are related to sex disease entity (TS vs. STEMI). Simply adjusting for sex in multivariable statistical models may not be enough if the sex disparity in the comparator groups is as large as it tends to be between STEMI and TS 20,28,29 . Nevertheless, the main observation in our study that ventricular arrhythmias are less common after TS than STEMI is consistent with previous studies 28,30 .…”

Section: Discussionsupporting

confidence: 82%

“…2,11 However, it is important to note that among patients with STEMI, ventricular arrhythmias are more common in men than women, 18 and most studies that compared the incidence of ventricular arrhythmias and outcome in STEMI vs. TS had more men in their STEMI groups vs. the TS groups. 7,19,20 It is also worth noting that the incidence of ventricular and other arrhythmias may differ between patients with anterior STEMI (in whom the large left anterior descending coronary artery is occluded) and patients with non-anterior STEMI (in whom the atrioventricular conduction system is more likely to be affected).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

et al. 2021

View full text Add to dashboard Cite

Aims The risk of life-threatening ventricular arrhythmias (LTVA) has been reported to be lower in Takotsubo syndrome (TS) compared with ST-elevation myocardial infarction (STEMI). However, the extent to which these differences relate to the fact that most patients with TS are women (who have a lower risk of LTVA) and a relatively larger proportion of patients with STEMI are men is incompletely understood. We aimed to investigate the risk of LTVA or death in sex-matched and age-matched patients with TS, anterior STEMI, and non-anterior STEMI. Methods and results We systematically reviewed the charts of all patients with TS who were treated at Sahlgrenska University Hospital (Gothenburg, Sweden) between 2008 and 2019. A total of 155 patients with confirmed TS (according to the European Society of Cardiology diagnostic criteria for TS) were sex-matched and age-matched 1:1:1 to patients with anterior and non-anterior STEMI. Baseline characteristics and in-hospital outcomes were recorded directly from the patient charts for all patients, and all admission electrocardiographs were analysed. The primary outcome was the composite of death or LTVA [defined as sustained ventricular tachycardia (>30 s) or ventricular fibrillation] within 72 h. The risk of LTVA or death within 72 h after admission was considerably lower in TS (2.6%) vs. anterior STEMI (14%; P = 0.002) and non-anterior STEMI (9.0%; P = 0.02), despite similar or greater risks of acute heart failure, and similar risks of cardiogenic shock. Compared with STEMI, TS was associated with a lower risk of sustained and non-sustained ventricular tachycardia and ventricular fibrillation. Conclusions In a predominantly female age-matched and sex-matched cohort of patients with TS, anterior STEMI, and non-anterior STEMI, the adjusted risk of in-hospital LTVA or death was considerably lower in TS compared with STEMI, despite similar or greater risk of acute heart failure and similar risk of cardiogenic shock.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 20 In a retrospective study of patients with TTS who were admitted for noncardiac issues ( n = 230), 23.5% presented with pneumonia upon admission. 23 Specific pneumonia-causing pathogens associated with TTS including Legionella pneumophila ( Supplementary material online, Reference S49 ), Streptococcus pneumonia , 24 influenza Type A virus ( Supplementary material online, Reference S47 ), Pseudomonas aeroginosa , 25 and COVID-19 pneumonia ( Supplementary material online, References S50–S53 and S55–S75 ) have been reported in previous case reports ( Supplementary material online, Table S3 ). Sepsis, both in general and as a result of pulmonary infections, has been associated with the development of apical ballooning.…”

Section: Resultsmentioning

confidence: 91%

Takotsubo syndrome and respiratory diseases: a systematic review

Wang

Liang

et al. 2022

European Heart Journal Open

View full text Add to dashboard Cite

Aims Takotsubo syndrome (TTS) is a rare cardiovascular condition characterized by reversible ventricular dysfunction and a presentation resembling that of acute myocardial infarction. An increasing number of studies has shown the association of respiratory diseases with TTS. Here, we comprehensively reviewed the literature and examined the available evidence for this association. Methods and Results After searching PubMed, EMBASE, and Cochrane Library databases, two investigators independently reviewed 3117 studies published through May 2021. Of these studies, 99 met the inclusion criteria (n = 108 patients). In patients with coexisting respiratory disease and TTS, the most common TTS symptom was dyspnea (70.48%), followed by chest pain (24.76%) and syncope (2.86%). The most common type of TTS was apical, accounting for 81.13% of cases, followed by the midventricular (8.49%), basal (8.49%), and biventricular (1.89%) types. Among the TTS cases, 39.82% were associated with obstructive lung disease and 38.89% were associated with pneumonia. Coronavirus disease 2019 (COVID-19), which has been increasingly reported in patients with TTS, was identified in 29 of 42 patients with pneumonia (69.05%). The overall mortality rate for patients admitted for respiratory disease complicated by TTS was 12.50%. Conclusion Obstructive lung disease and pneumonia are the most frequently identified respiratory triggers of TTS. Medications and invasive procedures utilized in managing respiratory diseases may also contribute to the development of TTS. Furthermore, the diagnosis of TTS triggered by these conditions can be challenging due to its atypical presentation. Future prospective studies are needed to establish appropriate guidelines for managing respiratory disease with concurrent TTS.

show abstract

“… 2 , 3 Although there are data comparing TS with MI, there are no published studies that compare TS with both type 1 and type 2 MI. 4 , 5 Moreover, the current literature on type 2 MI is primarily limited to small single‐center studies, and data on the prognosis of type 2 MI compared with type 1 MI are limited to mortality and readmission rates. 2 , 6 , 7 , 8 …”

mentioning

confidence: 99%

Outcomes of Patients With Takotsubo Syndrome Compared With Type 1 and Type 2 Myocardial Infarction

Khaloo,

Ledesma,

Nahlawi

et al. 2023

JAHA

View full text Add to dashboard Cite

Background Takotsubo syndrome (TS) and myocardial infarction (MI) share similar clinical and laboratory characteristics but have important differences in causes, demographics, management, and outcomes. Methods and Results In this observational study, the National Inpatient Sample and National Readmission Database were used to identify patients admitted with TS, type 1 MI, or type 2 MI in the United States between October 1, 2017, and December 31, 2019. We compared patients hospitalized with TS, type 1 MI, and type 2 MI with respect to key features and outcomes. Over the 27‐month study period, 2 035 055 patients with type 1 MI, 639 075 patients with type 2 MI, and 43 335 patients with TS were identified. Cardiac arrest, ventricular fibrillation, and ventricular tachycardia were more prevalent in type 1 MI (4.02%, 3.2%, and 7.2%, respectively) compared with both type 2 MI (2.8%, 0.8%, and 5.4% respectively) and TS (2.7%, 1.8%, and 5.3%, respectively). Risk of mortality was lower in TS compared with both type 1 MI (3.3% versus 7.9%; adjusted odds ratio [OR], 0.3; P <0.001) and type 2 MI (3.3% versus 8.2%; adjusted OR, 0.3; P <0.001). Mortality rate (OR, 1.2; P <0.001) and cardiac‐cause 30‐day readmission rate (adjusted OR, 1.7; P <0.001) were higher in type 1 MI than in type 2 MI. Conclusions Patients with type 1 MI had the highest rates of in‐hospital mortality and cardiac‐cause 30‐day readmission. Risk of all‐cause 30‐day readmission was highest in patients with type 2 MI. The risk of ventricular arrhythmias in patients with TS is lower than in patients with type 1 MI but higher than in patients with type 2 MI.

show abstract

In-hospital Takotsubo syndrome versus in-hospital acute myocardial infarction among patients admitted for non-cardiac diseases: a nationwide inpatient database study

Cited by 4 publications

References 43 publications

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

Takotsubo syndrome and respiratory diseases: a systematic review

Outcomes of Patients With Takotsubo Syndrome Compared With Type 1 and Type 2 Myocardial Infarction

Contact Info

Product

Resources

About