Age-related variations in Takotsubo syndrome

• Author(s): Cammann, Victoria L. ; Szawan, Konrad A. ; Stähli, Barbara E. ; Kato, Ken ; Budnik, Monika ; Wischnewsky, Manfred ; Dreiding, Sara ; Levinson, Rena A. ; Di Vece, Davide ; Gili, Sebastiano ; Citro, Rodolfo ; Shilova, Alexandra ; Gilyarov, Mikhail ; El-Battrawy, Ibrahim ; Akin, Ibrahim ; Poledniková, Karolina ; Toušek, Petr ; Winchester, David E. ; Galuszka, Jan ; Ukena, Christian ; Poglajen, Gregor ; Carrilho-Ferreira, Pedro ; Hauck, Christian ; Paolini, Carla ; Bilato, Claudio ; Kobayashi, Yoshio ; Shoji, Toshihiro ; Ishibashi, Iwao ; Takahara, Masayuki ; Himi, Toshiharu ; Din, Jehangir ; Al-Shammari, Ali ; Prasad, Abhiram ; Rihal, Charanjit S. ; Liu, Kan ; Schulze, P. Christian ; Bianco, Matteo ; Jörg, Lucas ; Rickli, Hans ; Pestana, Gonçalo ; Nguyen, Thanh H. ; Böhm, Michael ; Maier, Lars S. ; Pinto, Fausto J. ; Widimský, Petr ; Felix, Stephan B. ; Braun-Dullaeus, Ruediger C. ; Rottbauer, Wolfgang ; Hasenfuß, Gerd ; Pieske, Burkert M. ; Schunkert, Heribert ; Borggrefe, Martin ; Thiele, Holger ; Bauersachs, Johann ; Katus, Hugo A. ; Horowitz, John D. ; Di Mario, Carlo ; Münzel, Thomas ; Crea, Filippo ; Bax, Jeroen J. ; Lüscher, Thomas F. ; Ruschitzka, Frank ; Ghadri, Jelena R. ; Opolski, Grzegorz ; Templin, Christian ; Bossone, Eduardo ; Neuhaus, Michael ; Franke, Jennifer ; Meder, Benjamin ; Jaguszewski, Miłosz ; Noutsias, Michel ; Knorr, Maike ; Heiner, Susanne ; D’Ascenzo, Fabrizio ; Dichtl, Wolfgang ; Burgdorf, Christof ; Kherad, Behrouz ; Tschöpe, Carsten ; Sarcon, Annahita ; Shinbane, Jerold ; Rajan, Lawrence ; Michels, Guido ; Pfister, Roman ; Cuneo, Alessandro ; Jacobshagen, Claudius ; Karakas, Mahir ; Koenig, Wolfgang ; Pott, Alexander ; Meyer, Philippe ; Roffi, Marco ; Banning, Adrian ; Wolfrum, Mathias ; Cuculi, Florim ; Kobza, Richard ; Fischer, Thomas A. ; Vasankari, Tuija ; Airaksinen, K.E. Juhani ; Napp, L. Christian ; Dworakowski, Rafal ; MacCarthy, Philip ; Kaiser, Christoph ; Osswald, Stefan ; Galiuto, Leonarda ; Chan, Christina ; Bridgman, Paul ; Beug, Daniel ; Delmas, Clément ; Lairez, Olivier ; Gilyarova, Ekaterina
• Date: 2020
• Persistent ID: http://hdl.handle.net/10451/43297
• Origin: Repositório da Universidade de Lisboa
• Subject(s): Age; Broken heart syndrome; Outcome; Takotsubo syndrome
• Document Type: Journal article
• Language: English
• Contributor(s): Repositório Científico de Acesso Aberto da ULisboa

Description

BACKGROUND: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. OBJECTIVES: This study aimed to investigate age-related differences in TTS. METHODS: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: #50 years, middle-age: 51 to 74 years, elderly: $75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. RESULTS Of 2,098 TTS patients, 242 (11.5%) patients were #50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were $75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p ¼ 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p ¼ 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p ¼ 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p ¼ 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p ¼ 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p ¼ 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. CONCLUSIONS: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.