Takotsubo syndrome and chronic kidney disease - deadly duet in long-term follow-up

Zalewska-Adamiec, Małgorzata; Małyszko, Jolanta; Bachórzewska−Gajewska, Hanna; Tomaszuk‐Kazberuk, Anna; Kożuch, Marcin; Kralisz, Paweł; Dobrzycki, Sławomir

doi:10.20452/pamw.4309

Cited by 11 publications

(12 citation statements)

References 6 publications

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“…Another retrospective study of 95 TCM patients further illustrated the lack of in hospital mortality (p = .42) and 1‐year mortality difference (p = .72) in CKD‐TCM group compared to non‐CKD‐TCM group. The 3 years mortality was significantly higher in CKD‐TCM group (33.3% vs. 15.4%, p = .047) 36 …”

Section: Resultsmentioning

confidence: 93%

Conventional cardiovascular risk factors associated with Takotsubo cardiomyopathy: A comprehensive review

Liang

Zhang

et al. 2021

Clinical Cardiology

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Takotsubo cardiomyopathy (TCM), characterized by transient left ventricular dysfunction, was first reported in Japan in 1990. Current research suggests that TCM can be affected by conventional cardiovascular factors such as hypertension (HTN), diabetes, hyperlipidemia (HLD), and obesity. Despite the increasing interest in this disease, research on TCM remains limited. Conventional cardiovascular factors are clinically related to the outcome of TCM. We reviewed the publications published in PubMed database between January 01 2010 and January 15 2021, and summarized the most current available evidence on the correlation between TCM and the conventional cardiovascular factors. TCM patients are predominantly postmenopausal women. Men and young patients are less commonly seen, but are prone to acute adverse complications and poor prognosis. HTN is common in patients with recurrent TCM. Existing evidence suggests that obesity and chronic kidney disease are related to poor prognosis in TCM. HLD is reported to be associated with fewer complications, though current evidence is limited. Finally, the relationship between diabetes and TCM prognosis is ambivalent. Current evidence suggests conventional cardiovascular risk factors are associated with the outcome of TCM, especially with mortality and complications. More prospective studies are needed to clarify the relationship between each risk factor and the prognosis of TCM.

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Section: Resultsmentioning

confidence: 93%

Conventional cardiovascular risk factors associated with Takotsubo cardiomyopathy: A comprehensive review

Liang

Zhang

et al. 2021

Clinical Cardiology

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“…In our previous publication, low BMI proved to be a significant death risk factor during the 3-year observation of patients with TS [7], which prompted us to perform additional analyses in longer follow-up [7]. In recently published papers the BMI value is mainly described as the average value characterising the takotsubo group, or it is used to distinguish the group of obese patients [6,23].…”

Section: Discussionmentioning

confidence: 99%

“…Both early and late mortality is compared to mortality reported in non-ST segment elevation myocardial infarction (NSTEMI). Despite numerous clinical trials, the etiology of TS remains not entirely known, similarly to factors posing an influence on the prognosis [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Takotsubo syndrome – fatal prognosis of patients with low body mass index in 5-year follow-up

Zalewska-Adamiec¹,

Małyszko²,

Bachórzewska−Gajewska³

et al. 2020

aoms

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Introduction: The clinical courses of takotsubo syndrome (TS) and of acute coronary syndromes (ACS) seem to be very similar. However, there is limited knowledge about risk factors of poor outcomes. Low body mass index worsens the prognosis of patients with cardiovascular diseases, especially those undergoing surgical treatment. The aim of the study was to evaluate the influence of the body mass index (BMI) on the prognosis in patients diagnosed with TS. Material and methods: Eighty patients aged 15-89 (mean: 67.9 years), 74 women and 6 men with TS diagnosis according to Mayo Clinic diagnostic criteria were divided into 3 groups: low body mass (BMI < 18.5 kg/m 2), normal body mass (18.5 ≥ BMI < 25 kg/m 2) and excessive body mass (BMI ≥ 25 kg/m 2). Results: Patients with low BMI were older, but with less prevalent risk factors such as hypertension, hypercholesterolemia and positive family history of coronary artery disease and more frequent risk factors such as cigarette smoking, chronic obstructive pulmonary disease (COPD), depressive and anxiety disorders as well as malignancy. They also had higher haemoglobin, lower troponin, creatine kinase, C-reactive protein and lipid fractions. The highest annual, 3-year and 5-year mortality was observed in the group with BMI < 18.5 kg/m 2. None of the patients with low BMI survived the 5-year follow-up period (100% vs. 25% vs. 15.2%; p < 0.0001). In group III, mortality among overweight patients (25 ≥ BMI < 30 kg/m 2) was 8.3%, and in obese people (BMI ≥ 30 kg/m 2) 1 out 5 patients died during follow-up. Conclusions: The majority of typical cardiovascular risk factors are less frequently observed in patients with TS and low body mass. Early prognosis for TS patients and low BMI is relatively favourable, whereas the 5-year follow-up is associated with extremely high mortality. Overweight patients have the best prognosis in the long-term follow-up.

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“…ere is a greater risk of complications in takotsubo in patients with impaired renal function [16][17][18]. e pathomechanism of the disease has not yet been fully explained, and the methods to effectively treat those patients to prevent complications in the acute phase and the recurrence of the disease in the follow-up period remain unknown.…”

Section: Discussionmentioning

confidence: 99%

The GRACE scale in the prognosis of patients with Takotsubo syndrome

Zalewska-Adamiec

Kuźma

Dobrzycki

et al. 2020

European Heart Journal

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Background The prognosis of Takotsubo syndrome (TTS) is comparable to that of the non-ST-elevation myocardial infarction (NSTEMI). The GRACE scale is used to assess the risk of premature and long-term mortality in patients with NSTEMI in order to select the most favorable treatment strategy. Methods 101 patients with TTS were hospitalized in 4 centers of invasive cardiology in Podlaskie Voivodeship during the period 2008–2012 were included in the study. The patients were divided into 2 groups: I – 52 patients (GRACE ≤140 points) and II – 49 patients (GRACE >140 points). Results The mean GRACE score in study group was 138.66. The course of Takotsubo in the patients with higher GRACE scores was associated with higher incidence of pneumonia (36,7% vs 7,69%, p=0,0004), rhythm abnormalities (17,3% vs 3,85%, p=0,026) and serious complications (cardiogenic shock, pulmonary edema, and sudden cardiac arrest) (30,6% vs 5,77%, p=0,001). The mean observation period was 7.2 years. A significantly higher risk of 6-month (18,37% vs 3,85%, p=0,019),1-year (22,45 vs 3,85%, p=0,005), 3-year (40,82 vs 3,85%, p<0,0001), 5-year (42,86% vs 3,85%, p<0,0001) and 7-year mortality (53,06% vs 9,62%, p<0,0001) was observed in the group of patients with a GRACE score ≥140. The death risk factors in the multivariate analysis performed were low BMI, low eGFR, and a higher GRACE score The ROC curve presents the discriminatory scores of the GRACE scale for the follow-up prognosis. The area under ROC curve (AUC) for the GRACE scale was 0.805 (95% CI - 0.718–0.892, p<0.001), with a cut-off value of 153 points, sensitivity of 74%, and specificity of 77% for TTS. Conclusion The GRACE scale is highly valuable for the prognosis of death risk in patients with TTS in the early and follow-up period. Funding Acknowledgement Type of funding source: None

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Takotsubo syndrome and chronic kidney disease - deadly duet in long-term follow-up

Cited by 11 publications

References 6 publications

Conventional cardiovascular risk factors associated with Takotsubo cardiomyopathy: A comprehensive review

Conventional cardiovascular risk factors associated with Takotsubo cardiomyopathy: A comprehensive review

Takotsubo syndrome – fatal prognosis of patients with low body mass index in 5-year follow-up

The GRACE scale in the prognosis of patients with Takotsubo syndrome

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