Abstract
Background
Characteristics and outcomes of patients with takotsubo syndrome remain to be defined.
The goal of this study was to report the characteristics and long-term outcomes of
patients presenting with takotsubo syndrome compared with other patients presenting
with acute myocardial infarction (AMI) in a community-based population.
Methods
This retrospective population-based study included patients hospitalised for AMI from
2006 to 2016. Those patients with takotsubo syndrome were compared with the patients
with AMI. The primary outcome was all-cause mortality. Matching was performed to assemble
a cohort of patients with similar baseline characteristics.
Results
Among 26,015 patients hospitalised with an initial diagnosis of AMI, 530 (2.0%) were
diagnosed with takotsubo syndrome. Patients with takotsubo syndrome were older (68.3
± 11.3 vs 65.6 ± 12.2 years) and more likely to be women (93.4% vs 30.7%). Concomitant
hypothyroidism, rheumatologic disorders, and lung disease were more prevalent in the
takotsubo syndrome group, whereas diabetes and hyperlipidemia were less prevalent.
Mortality was lower in the takotsubo syndrome group (1-year mortality 4.0% vs 8.9%;
P < 0.001). The 530 patients with takotsubo syndrome were matched with 1,315 AMI patients
with similar baseline characteristics. At a follow-up of 5.4 ± 3.3 years, patients
with takotsubo syndrome had a lower risk for all-cause death than other patients who
presented with AMI (hazard ratio 0.59, 95% CI 0.47-0.76).
Conclusions
Among patients presenting with AMI, patients with takotsubo syndrome were older and
more likely to be women. Patients with takotsubo syndrome had better long-term outcomes
compared with matched AMI patients.
Résumé
Contexte
Les caractéristiques et le pronostic des patients atteints du syndrome de Takotsubo
restent à définir. L'objectif de cette étude était de rapporter les caractéristiques
et le pronostic à long terme des patients présentant un syndrome de Takotsubo par
rapport à d'autres patients présentant un infarctus aigu du myocarde (IAM) dans une
population à modèle communautaire.
Méthodes
Cette étude de population rétrospective comprenait des patients hospitalisés pour
un IAM entre 2006 et 2016. Les patients atteints du syndrome de Takotsubo ont été
comparés aux patients présentant un IAM. Le principal critère d'évaluation était la
mortalité toutes causes confondues. Un appariement a été réalisé pour assembler une
cohorte de patients présentant des caractéristiques de référence similaires.
Résultats
Parmi les 26 015 patients hospitalisés avec un diagnostic initial d'IAM, 530 (2,0
%) ont reçu un diagnostic de syndrome de Takotsubo. Les patients atteints du syndrome
de Takotsubo étaient plus âgés (68,3 ± 11,3 vs 65,6 ± 12,2 ans) et plus souvent des
femmes (93,4 % vs 30,7 %). Une hypothyroïdie concomitante, des troubles rhumatologiques
et des pneumopathies étaient plus fréquemment relevés dans le groupe présentant un
syndrome de Takotsubo, tandis qu'un diabète et une hyperlipidémie étaient moins fréquents.
La mortalité était plus faible dans le groupe présentant un syndrome de Takotsubo
(mortalité à 1 an 4,0 % contre 8,9 % ; P < 0,001). Les 530 patients atteints du syndrome de Takotsubo ont été appariés avec
1 315 patients ayant subi un IAM et présentant des caractéristiques de référence similaires.
Après un suivi de 5,4 ± 3,3 ans, les patients atteints du syndrome de Takotsubo présentaient
un risque de décès toutes causes confondues plus faible que les autres patients ayant
présentés un IAM (rapport des risques instantanés 0,59, intervalle de confiance à
95 % : 0,47-0,76).
Conclusions
Parmi les patients présentant un IAM, les patients atteints du syndrome de Takotsubo
étaient plus âgés et plus souvent des femmes. Les patients atteints du syndrome de
Takotsubo avaient de meilleurs pronostics à long terme par rapport aux patients apparié
qui présentaient un IAM.
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Article info
Publication history
Published online: January 20, 2021
Accepted:
January 13,
2021
Received:
November 12,
2020
Footnotes
See page 1196 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
