Physically triggered Takotsubo cardiomyopathy has a higher in-hospital mortality rate

Yoshihiro Sobue, Eiichi Watanabe, Tomohide Ichikawa, Masayuki Koshikawa, Mayumi Yamamoto, Masahide Harada, Yukio Ozaki

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background Takotsubo cardiomyopathy (TC) is a myopathy triggered by severe stressful events. However, little is known about the determinants of in-hospital outcomes. We prospectively determined the effect of different triggers on the prognosis of TC. Methods and results We enrolled patients who were admitted for suspected acute coronary syndrome (ACS) from January 2008 to December 2015. TC was diagnosed according to the Mayo Clinic diagnosis criteria. The outcome was in-hospital death. Among 1861 consecutive patients with suspected ACS, 82 (4.4%) patients were diagnosed with TC. There were 43 patients (52%) with physical triggers (Physical), 26 (31%) with emotional triggers, and 13 (17%) with no identifiable triggers. The latter two groups were combined and categorized as the Non-physical trigger group. Compared with non-physical triggered TC, patients with physical triggered TC were more likely to have a malignancy (p = 0.008), lower blood pressure (p = 0.001), lower hemoglobin (p < 0.001), higher serum creatinine (p < 0.001) and higher norepinephrine levels (p = 0.007). During a mean hospital stay of 16 ± 12 days, 9 (20.9%) of the Physical and 1 (2.6%) of the Non-physical patients died in-hospital (log-rank p = 0.007). After adjusting for the age, gender, trigger, malignancy, and hemoglobin level, being male (hazard ratio 11.9, 95% confidence interval, 2.43–58.5, p = 0.002) and having a physical trigger (14.7, 1.19–166, p = 0.03) were associated with in-hospital mortality. Conclusion There was a significant difference in in-hospital mortality depending on the trigger type in TC. Being male and having a physical trigger were independent risk factors of in-hospital mortality from TC.

Original languageEnglish
Pages (from-to)87-93
Number of pages7
JournalInternational Journal of Cardiology
Volume235
DOIs
Publication statusPublished - 15-05-2017

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Takotsubo Cardiomyopathy
Hospital Mortality
Mortality
Acute Coronary Syndrome
Hemoglobins
Muscular Diseases
Length of Stay
Creatinine
Neoplasms
Norepinephrine
Confidence Intervals
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Sobue, Yoshihiro ; Watanabe, Eiichi ; Ichikawa, Tomohide ; Koshikawa, Masayuki ; Yamamoto, Mayumi ; Harada, Masahide ; Ozaki, Yukio. / Physically triggered Takotsubo cardiomyopathy has a higher in-hospital mortality rate. In: International Journal of Cardiology. 2017 ; Vol. 235. pp. 87-93.
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title = "Physically triggered Takotsubo cardiomyopathy has a higher in-hospital mortality rate",
abstract = "Background Takotsubo cardiomyopathy (TC) is a myopathy triggered by severe stressful events. However, little is known about the determinants of in-hospital outcomes. We prospectively determined the effect of different triggers on the prognosis of TC. Methods and results We enrolled patients who were admitted for suspected acute coronary syndrome (ACS) from January 2008 to December 2015. TC was diagnosed according to the Mayo Clinic diagnosis criteria. The outcome was in-hospital death. Among 1861 consecutive patients with suspected ACS, 82 (4.4{\%}) patients were diagnosed with TC. There were 43 patients (52{\%}) with physical triggers (Physical), 26 (31{\%}) with emotional triggers, and 13 (17{\%}) with no identifiable triggers. The latter two groups were combined and categorized as the Non-physical trigger group. Compared with non-physical triggered TC, patients with physical triggered TC were more likely to have a malignancy (p = 0.008), lower blood pressure (p = 0.001), lower hemoglobin (p < 0.001), higher serum creatinine (p < 0.001) and higher norepinephrine levels (p = 0.007). During a mean hospital stay of 16 ± 12 days, 9 (20.9{\%}) of the Physical and 1 (2.6{\%}) of the Non-physical patients died in-hospital (log-rank p = 0.007). After adjusting for the age, gender, trigger, malignancy, and hemoglobin level, being male (hazard ratio 11.9, 95{\%} confidence interval, 2.43–58.5, p = 0.002) and having a physical trigger (14.7, 1.19–166, p = 0.03) were associated with in-hospital mortality. Conclusion There was a significant difference in in-hospital mortality depending on the trigger type in TC. Being male and having a physical trigger were independent risk factors of in-hospital mortality from TC.",
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Physically triggered Takotsubo cardiomyopathy has a higher in-hospital mortality rate. / Sobue, Yoshihiro; Watanabe, Eiichi; Ichikawa, Tomohide; Koshikawa, Masayuki; Yamamoto, Mayumi; Harada, Masahide; Ozaki, Yukio.

In: International Journal of Cardiology, Vol. 235, 15.05.2017, p. 87-93.

Research output: Contribution to journalArticle

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T1 - Physically triggered Takotsubo cardiomyopathy has a higher in-hospital mortality rate

AU - Sobue, Yoshihiro

AU - Watanabe, Eiichi

AU - Ichikawa, Tomohide

AU - Koshikawa, Masayuki

AU - Yamamoto, Mayumi

AU - Harada, Masahide

AU - Ozaki, Yukio

PY - 2017/5/15

Y1 - 2017/5/15

N2 - Background Takotsubo cardiomyopathy (TC) is a myopathy triggered by severe stressful events. However, little is known about the determinants of in-hospital outcomes. We prospectively determined the effect of different triggers on the prognosis of TC. Methods and results We enrolled patients who were admitted for suspected acute coronary syndrome (ACS) from January 2008 to December 2015. TC was diagnosed according to the Mayo Clinic diagnosis criteria. The outcome was in-hospital death. Among 1861 consecutive patients with suspected ACS, 82 (4.4%) patients were diagnosed with TC. There were 43 patients (52%) with physical triggers (Physical), 26 (31%) with emotional triggers, and 13 (17%) with no identifiable triggers. The latter two groups were combined and categorized as the Non-physical trigger group. Compared with non-physical triggered TC, patients with physical triggered TC were more likely to have a malignancy (p = 0.008), lower blood pressure (p = 0.001), lower hemoglobin (p < 0.001), higher serum creatinine (p < 0.001) and higher norepinephrine levels (p = 0.007). During a mean hospital stay of 16 ± 12 days, 9 (20.9%) of the Physical and 1 (2.6%) of the Non-physical patients died in-hospital (log-rank p = 0.007). After adjusting for the age, gender, trigger, malignancy, and hemoglobin level, being male (hazard ratio 11.9, 95% confidence interval, 2.43–58.5, p = 0.002) and having a physical trigger (14.7, 1.19–166, p = 0.03) were associated with in-hospital mortality. Conclusion There was a significant difference in in-hospital mortality depending on the trigger type in TC. Being male and having a physical trigger were independent risk factors of in-hospital mortality from TC.

AB - Background Takotsubo cardiomyopathy (TC) is a myopathy triggered by severe stressful events. However, little is known about the determinants of in-hospital outcomes. We prospectively determined the effect of different triggers on the prognosis of TC. Methods and results We enrolled patients who were admitted for suspected acute coronary syndrome (ACS) from January 2008 to December 2015. TC was diagnosed according to the Mayo Clinic diagnosis criteria. The outcome was in-hospital death. Among 1861 consecutive patients with suspected ACS, 82 (4.4%) patients were diagnosed with TC. There were 43 patients (52%) with physical triggers (Physical), 26 (31%) with emotional triggers, and 13 (17%) with no identifiable triggers. The latter two groups were combined and categorized as the Non-physical trigger group. Compared with non-physical triggered TC, patients with physical triggered TC were more likely to have a malignancy (p = 0.008), lower blood pressure (p = 0.001), lower hemoglobin (p < 0.001), higher serum creatinine (p < 0.001) and higher norepinephrine levels (p = 0.007). During a mean hospital stay of 16 ± 12 days, 9 (20.9%) of the Physical and 1 (2.6%) of the Non-physical patients died in-hospital (log-rank p = 0.007). After adjusting for the age, gender, trigger, malignancy, and hemoglobin level, being male (hazard ratio 11.9, 95% confidence interval, 2.43–58.5, p = 0.002) and having a physical trigger (14.7, 1.19–166, p = 0.03) were associated with in-hospital mortality. Conclusion There was a significant difference in in-hospital mortality depending on the trigger type in TC. Being male and having a physical trigger were independent risk factors of in-hospital mortality from TC.

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