Prevalence of malignant arrhythmia and sudden cardiac death in takotsubo syndrome and its management
Recent studies have highlighted that takotsubo syndrome (TTS) is associated with a poor clinical outcome. Our study was conducted to determine the short- and long-term prevalence, recurrence rate and impact of life-threatening arrhythmias (LTA) on the clinical outcome of TTS. Our institutional datab...
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| Veröffentlicht in: | Europace (London, England) England), 2018-05, Vol.20 (5), p.843-850 |
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| creator | El-Battrawy, Ibrahim Lang, Siegfried Ansari, Uzair Tülümen, Erol Schramm, Katja Fastner, Christian Zhou, Xiaobo Hoffmann, Ursula Borggrefe, Martin Akin, Ibrahim |
| description | Recent studies have highlighted that takotsubo syndrome (TTS) is associated with a poor clinical outcome. Our study was conducted to determine the short- and long-term prevalence, recurrence rate and impact of life-threatening arrhythmias (LTA) on the clinical outcome of TTS.
Our institutional database constituted a collective of 114 patients diagnosed with TTS between 2003 and 2015. The patient groups, divided according to the presence (n = 13, 11.4%) or absence (n = 101, 88.6%) of LTAs, were followed-up over a period of 3 years so as to determine the clinical outcome. Our analyses suggest that patients comprising the LTA group suffered significantly more often from an acute cardiovascular event including cases of a newly diagnosed atrial fibrillation (38.4% vs. 2.9%), cardiogenic shock with use of inotropic agents (53.8% vs. 14.8%) and cardiopulmonary resuscitation (61.5% vs. 1%). The short-term recurrence rate of a LTA episode was 15.3%, while the long-term recurrence rate of any LTA was around 5%. Whereas, in-hospital mortality was significantly higher in TTS associated with LTAs, the overall survival rate over 3 years was similar. A multivariate Cox regression analysis suggested atrial fibrillation, EF ≤ 35%, cardiogenic shock, and glomerular filtration rate |
| doi_str_mv | 10.1093/europace/eux073 |
| format | Article |
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Our institutional database constituted a collective of 114 patients diagnosed with TTS between 2003 and 2015. The patient groups, divided according to the presence (n = 13, 11.4%) or absence (n = 101, 88.6%) of LTAs, were followed-up over a period of 3 years so as to determine the clinical outcome. Our analyses suggest that patients comprising the LTA group suffered significantly more often from an acute cardiovascular event including cases of a newly diagnosed atrial fibrillation (38.4% vs. 2.9%), cardiogenic shock with use of inotropic agents (53.8% vs. 14.8%) and cardiopulmonary resuscitation (61.5% vs. 1%). The short-term recurrence rate of a LTA episode was 15.3%, while the long-term recurrence rate of any LTA was around 5%. Whereas, in-hospital mortality was significantly higher in TTS associated with LTAs, the overall survival rate over 3 years was similar. A multivariate Cox regression analysis suggested atrial fibrillation, EF ≤ 35%, cardiogenic shock, and glomerular filtration rate <60 mL/min. as independent predictors of adverse outcome.
The short- as well as the long-term prevalence and recurrence of LTAs in TTS patients is high. The long-term mortality rates were similar to the TTS patients presenting without any LTAs. LTAs in TTS could be triggered by a concomitant atrial fibrillation.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/eux073</identifier><identifier>PMID: 28453621</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - mortality ; Cardiopulmonary Resuscitation - statistics & numerical data ; Cardiotonic Agents - therapeutic use ; Death, Sudden, Cardiac - epidemiology ; Death, Sudden, Cardiac - etiology ; Female ; Germany - epidemiology ; Hospital Mortality ; Humans ; Long Term Adverse Effects - diagnosis ; Long Term Adverse Effects - epidemiology ; Male ; Middle Aged ; Prevalence ; Recurrence ; Risk Factors ; Shock, Cardiogenic - drug therapy ; Shock, Cardiogenic - epidemiology ; Shock, Cardiogenic - etiology ; Survival Rate ; Takotsubo Cardiomyopathy - complications ; Takotsubo Cardiomyopathy - epidemiology</subject><ispartof>Europace (London, England), 2018-05, Vol.20 (5), p.843-850</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-9a8e256f7ff98cccc154a64c2c120f4d48fc5c89b26a5c0521cf8b3b609508cc3</citedby><cites>FETCH-LOGICAL-c404t-9a8e256f7ff98cccc154a64c2c120f4d48fc5c89b26a5c0521cf8b3b609508cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28453621$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>El-Battrawy, Ibrahim</creatorcontrib><creatorcontrib>Lang, Siegfried</creatorcontrib><creatorcontrib>Ansari, Uzair</creatorcontrib><creatorcontrib>Tülümen, Erol</creatorcontrib><creatorcontrib>Schramm, Katja</creatorcontrib><creatorcontrib>Fastner, Christian</creatorcontrib><creatorcontrib>Zhou, Xiaobo</creatorcontrib><creatorcontrib>Hoffmann, Ursula</creatorcontrib><creatorcontrib>Borggrefe, Martin</creatorcontrib><creatorcontrib>Akin, Ibrahim</creatorcontrib><title>Prevalence of malignant arrhythmia and sudden cardiac death in takotsubo syndrome and its management</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>Recent studies have highlighted that takotsubo syndrome (TTS) is associated with a poor clinical outcome. Our study was conducted to determine the short- and long-term prevalence, recurrence rate and impact of life-threatening arrhythmias (LTA) on the clinical outcome of TTS.
Our institutional database constituted a collective of 114 patients diagnosed with TTS between 2003 and 2015. The patient groups, divided according to the presence (n = 13, 11.4%) or absence (n = 101, 88.6%) of LTAs, were followed-up over a period of 3 years so as to determine the clinical outcome. Our analyses suggest that patients comprising the LTA group suffered significantly more often from an acute cardiovascular event including cases of a newly diagnosed atrial fibrillation (38.4% vs. 2.9%), cardiogenic shock with use of inotropic agents (53.8% vs. 14.8%) and cardiopulmonary resuscitation (61.5% vs. 1%). The short-term recurrence rate of a LTA episode was 15.3%, while the long-term recurrence rate of any LTA was around 5%. Whereas, in-hospital mortality was significantly higher in TTS associated with LTAs, the overall survival rate over 3 years was similar. A multivariate Cox regression analysis suggested atrial fibrillation, EF ≤ 35%, cardiogenic shock, and glomerular filtration rate <60 mL/min. as independent predictors of adverse outcome.
The short- as well as the long-term prevalence and recurrence of LTAs in TTS patients is high. The long-term mortality rates were similar to the TTS patients presenting without any LTAs. LTAs in TTS could be triggered by a concomitant atrial fibrillation.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Arrhythmias, Cardiac - mortality</subject><subject>Cardiopulmonary Resuscitation - statistics & numerical data</subject><subject>Cardiotonic Agents - therapeutic use</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Long Term Adverse Effects - diagnosis</subject><subject>Long Term Adverse Effects - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Shock, Cardiogenic - drug therapy</subject><subject>Shock, Cardiogenic - epidemiology</subject><subject>Shock, Cardiogenic - etiology</subject><subject>Survival Rate</subject><subject>Takotsubo Cardiomyopathy - complications</subject><subject>Takotsubo Cardiomyopathy - epidemiology</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAURS0EoqUwsyGPLKG2EyfxiCq-pEowwBy92M9tIHGK7SD67wm05S3vDufe4RByydkNZyqd4-D7DWgcwzcr0iMy5TIViWBKHI-ZKZVILtSEnIXwzhgrhJKnZCLKTKa54FNiXjx-QYtOI-0t7aBtVg5cpOD9ehvXXQMUnKFhMAYd1eBNA5oahLimjaMRPvoYhrqnYeuM7zv8w5sYxi0HK-zQxXNyYqENeLH_M_J2f_e6eEyWzw9Pi9tlojOWxURBiULmtrBWlXo8LjPIMy00F8xmJiutlrpUtchBaiYF17as0zpnSrKxkM7I9W534_vPAUOsuiZobFtw2A-h4qVKZVYoJUZ0vkO170PwaKuNbzrw24qz6ldtdVBb7dSOjav9-FB3aP75g8v0B5NYeb8</recordid><startdate>20180501</startdate><enddate>20180501</enddate><creator>El-Battrawy, Ibrahim</creator><creator>Lang, Siegfried</creator><creator>Ansari, Uzair</creator><creator>Tülümen, Erol</creator><creator>Schramm, Katja</creator><creator>Fastner, Christian</creator><creator>Zhou, Xiaobo</creator><creator>Hoffmann, Ursula</creator><creator>Borggrefe, Martin</creator><creator>Akin, Ibrahim</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180501</creationdate><title>Prevalence of malignant arrhythmia and sudden cardiac death in takotsubo syndrome and its management</title><author>El-Battrawy, Ibrahim ; Lang, Siegfried ; Ansari, Uzair ; Tülümen, Erol ; Schramm, Katja ; Fastner, Christian ; Zhou, Xiaobo ; Hoffmann, Ursula ; Borggrefe, Martin ; Akin, Ibrahim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-9a8e256f7ff98cccc154a64c2c120f4d48fc5c89b26a5c0521cf8b3b609508cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - diagnosis</topic><topic>Arrhythmias, Cardiac - etiology</topic><topic>Arrhythmias, Cardiac - mortality</topic><topic>Cardiopulmonary Resuscitation - statistics & numerical data</topic><topic>Cardiotonic Agents - therapeutic use</topic><topic>Death, Sudden, Cardiac - epidemiology</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Long Term Adverse Effects - diagnosis</topic><topic>Long Term Adverse Effects - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Shock, Cardiogenic - drug therapy</topic><topic>Shock, Cardiogenic - epidemiology</topic><topic>Shock, Cardiogenic - etiology</topic><topic>Survival Rate</topic><topic>Takotsubo Cardiomyopathy - complications</topic><topic>Takotsubo Cardiomyopathy - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El-Battrawy, Ibrahim</creatorcontrib><creatorcontrib>Lang, Siegfried</creatorcontrib><creatorcontrib>Ansari, Uzair</creatorcontrib><creatorcontrib>Tülümen, Erol</creatorcontrib><creatorcontrib>Schramm, Katja</creatorcontrib><creatorcontrib>Fastner, Christian</creatorcontrib><creatorcontrib>Zhou, Xiaobo</creatorcontrib><creatorcontrib>Hoffmann, Ursula</creatorcontrib><creatorcontrib>Borggrefe, Martin</creatorcontrib><creatorcontrib>Akin, Ibrahim</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El-Battrawy, Ibrahim</au><au>Lang, Siegfried</au><au>Ansari, Uzair</au><au>Tülümen, Erol</au><au>Schramm, Katja</au><au>Fastner, Christian</au><au>Zhou, Xiaobo</au><au>Hoffmann, Ursula</au><au>Borggrefe, Martin</au><au>Akin, Ibrahim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of malignant arrhythmia and sudden cardiac death in takotsubo syndrome and its management</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2018-05-01</date><risdate>2018</risdate><volume>20</volume><issue>5</issue><spage>843</spage><epage>850</epage><pages>843-850</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>Recent studies have highlighted that takotsubo syndrome (TTS) is associated with a poor clinical outcome. Our study was conducted to determine the short- and long-term prevalence, recurrence rate and impact of life-threatening arrhythmias (LTA) on the clinical outcome of TTS.
Our institutional database constituted a collective of 114 patients diagnosed with TTS between 2003 and 2015. The patient groups, divided according to the presence (n = 13, 11.4%) or absence (n = 101, 88.6%) of LTAs, were followed-up over a period of 3 years so as to determine the clinical outcome. Our analyses suggest that patients comprising the LTA group suffered significantly more often from an acute cardiovascular event including cases of a newly diagnosed atrial fibrillation (38.4% vs. 2.9%), cardiogenic shock with use of inotropic agents (53.8% vs. 14.8%) and cardiopulmonary resuscitation (61.5% vs. 1%). The short-term recurrence rate of a LTA episode was 15.3%, while the long-term recurrence rate of any LTA was around 5%. Whereas, in-hospital mortality was significantly higher in TTS associated with LTAs, the overall survival rate over 3 years was similar. A multivariate Cox regression analysis suggested atrial fibrillation, EF ≤ 35%, cardiogenic shock, and glomerular filtration rate <60 mL/min. as independent predictors of adverse outcome.
The short- as well as the long-term prevalence and recurrence of LTAs in TTS patients is high. The long-term mortality rates were similar to the TTS patients presenting without any LTAs. LTAs in TTS could be triggered by a concomitant atrial fibrillation.</abstract><cop>England</cop><pmid>28453621</pmid><doi>10.1093/europace/eux073</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford Journals Open Access Collection; MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - mortality Cardiopulmonary Resuscitation - statistics & numerical data Cardiotonic Agents - therapeutic use Death, Sudden, Cardiac - epidemiology Death, Sudden, Cardiac - etiology Female Germany - epidemiology Hospital Mortality Humans Long Term Adverse Effects - diagnosis Long Term Adverse Effects - epidemiology Male Middle Aged Prevalence Recurrence Risk Factors Shock, Cardiogenic - drug therapy Shock, Cardiogenic - epidemiology Shock, Cardiogenic - etiology Survival Rate Takotsubo Cardiomyopathy - complications Takotsubo Cardiomyopathy - epidemiology |
| title | Prevalence of malignant arrhythmia and sudden cardiac death in takotsubo syndrome and its management |
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