Core Concepts
Patients with Takotsubo Syndrome have higher mortality rates compared to the general population and similar rates to those with myocardial infarction.
Abstract
TOPLINE:
Mortality in Takotsubo Syndrome (TTS) is higher than the general population and comparable to myocardial infarction (MI).
Medication use rates are similar for TTS and MI despite no specific clinical trials or recommendations.
METHODOLOGY:
Study included 620 Scottish patients with TTS, predominantly middle-aged women.
Analysis included control groups from the general population and patients with acute MI.
Data extracted on medication prescribing, causes of death, and major causes of death clustered into 17 groups.
TAKEAWAY:
All-cause mortality higher in TTS than the general population and slightly lower than in MI.
Cardiovascular causes, especially heart failure, most strongly associated with TTS.
Prescription rates of medications similar between TTS and MI.
IN PRACTICE:
Findings may lead to further exploration of mechanisms and treatments for TTS.
Importance of research for better management of TTS patients highlighted.
SOURCE:
Research led by Amelia E. Rudd, published in the Journal of the College of Cardiology.
LIMITATIONS:
Complete alignment of clinical characteristics between TTS and MI patients not feasible.
TTS still relatively unfamiliar to clinicians during the study.
Causality cannot be assumed due to nonrandomized data.
DISCLOSURES:
Rudd had no conflicts of interest. Study author Dana K. Dawson received awards for the study.
Stats
"All-cause mortality was higher in patients with TTS than in the general population (hazard ratio [HR], 1.78; 95% CI, 1.48-2.15; P < .001) and slightly lower than in patients having MI (HR, 0.76; 95% CI, 0.62-0.94; P = .012)."
"Cardiovascular causes, particularly heart failure, being the most strongly associated with TTS (HR, 2.47; 95% CI, 1.81-3.39; P < .0001 vs general population)."
"The only cardiovascular therapy associated with lower mortality in patients with TTS was angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy (P = .0056)."
Quotes
"These findings may help to lay the foundations for further exploration of potential mechanisms and treatments" - Authors
"The study suggests the importance of further research for more appropriate management of patients with acute and long-term TTS." - Commentary