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. 2016 Sep;24(9):511-9.
doi: 10.1007/s12471-016-0857-z.

Takotsubo cardiomyopathy: serious early complications and two-year mortality - a 101 case study

M Zalewska-Adamiec  1 , H Bachorzewska-Gajewska  2 , A Tomaszuk-Kazberuk  3 , K Nowak  2 , P Drozdowski  4 , J Bychowski  5 , R Krynicki  6 , W J Musial  3 , S Dobrzycki  2
Affiliations

Takotsubo cardiomyopathy: serious early complications and two-year mortality - a 101 case study

M Zalewska-Adamiec et al. Neth Heart J. 2016 Sep.

Abstract

Background: Takotsubo cardiomyopathy (TTC) is characterised by transient contractility disturbances of the apex of the left ventricle.

Methods: We enrolled 101 patients from the northern-eastern part of Poland in the years 2008-2012 who were hospitalised for TCC. The control group consisted of female patients diagnosed with anterior myocardial infarction with ST-segment elevation (anterior STEMI) (n = 101).

Results: 89 % of the study group were women. Patients with TTC had diabetes (12.6 % vs 29.7 %; p = 0.002) and hyperlipidaemia (36.8 % vs 64.4 %; p = 0.0001) significantly less frequently, and better kidney function assessed by estimated glomerular filtration rate versus patients with anterior STEMI (74.52 % vs 64.30 %; p = 0.004). In the TTC group there were more patients with chronic obstructive pulmonary disease (11.6 % vs 1.0 %; p = 0.002) and thyroid disturbances, especially hyperthyroidism (23.4 % vs 11.0 %; p = 0.021). In patients with TTC sudden cardiac arrest, pulmonary oedema and cardiogenic shock were observed less frequently than in the control group (14.7 % vs 30.7 %; p = 0.0078). Hospitalisations in TTC patients were less frequently complicated by pneumonia (20.0 % vs 35.6 %; p = 0.0148) and urinary infection (4.2 % vs 21.8 %; p = 0.0003). Cardiac rupture occurred in 3 patients with TTC and in 1 with anterior STEMI. In-hospital mortality was significantly lower in the group with TTC. Also, mortality at 30 days, 3 months, 1 year and 2.5 years was significantly lower in patients with TTC than in patients with MI (p = 0.035; p = 0.0226; p = 0.0075; p = 0.009).

Conclusions: Previously considered to be a benign syndrome, TTC should be reconsidered as a clinical condition at risk for serious complications such as cardiac arrest, cardiogenic shock, pulmonary oedema and cardiac rupture leading to death and causing substantial early hazard. The prognosis in TTC is significantly better than in patients with anterior STEMI.

Keywords: Anterior myocardial infarction; Takotsubo cardiomyopathy.

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Conflict of interest statement

Conflict of interestM. Zalewska-Adamiec, H. Bachorzewska-Gajewska, A. Tomaszuk-Kazberuk, K. Nowak, P. Drozdowski, J. Bychowski, R. Krynicki, W.J. Musial and S. Dobrzycki state that there are no conflicts of interest.

Figures

Fig. 1a–d
Fig. 1a–d
Kaplan-Meier curves showing survival in patients diagnosed with Takotsubo cardiomyopathy and anterior ST-segment elevation myocardial infarction at 30-day, 3‑month, 1‑year and 2.5-year follow-up
See this image and copyright information in PMC

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