Clinical Features and Outcomes of Takotsubo Syndrome at a University Hospital

pp 88-93

Abstract

Background: Takotsubo syndrome (TS) is a reversible cardiomyopathy with many different forms of presentations. There is no local data of TS published so far.
Methods: One hundred and fifteen patients with either primary or secondary TS were retrospectively studied at Hospital Italiano de Buenos Aires from 2005 to 2017. The purpose of the study was to assess the clinical features of this population during hospitalization.
Results: Median of age was 78 years (64-84); 90 % of patients were female, and 22% had associated coronary artery disease. Fiftyseven percent of cases were primary TS, 31 % experienced an emotional trigger and 44 % had a physical origin. The presentation syndrome was as follows: 9 % shock, 12 % heart failure, 70 % mimicking acute coronary syndrome, 5 % stroke/peripheral embolism
and 4 % arrhythmias. Median ejection fraction at admission was 40 % (36-50) and recovery from admission to discharge [median hospital stay: 4 days (3-8)] was 20 %, p <0.001. In-hospital mortality was 4/115 cases (3.48 %). In univariate analysis, shock compared with other forms of presentation (p=0.0035) and secondary TS (p=0.020) were associated with higher in-hospital mortality. There was a direct relationship between in-hospital mortality and maximum NT-pro-BNP levels (p= 0.0082) and white cell count (p=0.0101).
In addition, in-hospital mortality was inversely associated with hematocrit (p=0.0084) and with ECG abnormalities at admission;i.e. patients who died during hospitalization had more frequently normal ECG at admission, (p<0.001).
Conclusion: Compared with international registries, this single center population had more comorbidities, but similar in-hospital mortality rates.