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Mousavi RA, Schober A, Kronberger C, Han E, Litschauer B, Pichler G, Badr Eslam R. Effects of cardiovascular risk factors and pre-existing diseases on the short-term outcome of Takotsubo syndrome. Wien Klin Wochenschr 2024:10.1007/s00508-024-02326-4. [PMID: 38319434 DOI: 10.1007/s00508-024-02326-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND The effects of cardiovascular risk factors (CVRF) on the development of most acute cardiac conditions are well established; however, little is known about the frequency and effects of CVRF in Takotsubo syndrome (TTS) patients. OBJECTIVE The aim of our study was to compare the frequency of CVRF and pre-existing diseases (PD) of TTS patients to ST-elevation myocardial infarction (STEMI) patients and analyze their effects on short-term outcome. METHODS We analyzed the frequency of CVRF (hypertension, hyperlipidemia, type II diabetes mellitus, smoking, chronic kidney disease, family history) as well as somatic and psychiatric PD at admission in TTS patients and compared them with STEMI patients. Their effect on short-term outcome was calculated using a combined endpoint of cardiogenic shock, cardiopulmonary resuscitation, mechanical ventilation, and/or in-hospital death. RESULTS In total, 150 TTS and 155 STEMI patients were included in our study. We observed a higher frequency of psychiatric (30% vs. 7%, p < 0.001), neurological (5% vs. 0%, p = 0.01), and pulmonary (18% vs. 5%, p < 0.001) PD in TTS patients as compared to STEMI patients. There were less smokers (47% vs. 61%, p = 0.03) and patients with hyperlipidemia (24% vs. 51%, p < 0.001) in the TTS cohort than in the STEMI cohort. None of the CVRF or PD behaved as an independent predictor for adverse short-term outcome in TTS patients. CONCLUSION Psychiatric, neurological, and pulmonary pre-existing diseases are more common in TTS than in STEMI patients. Interestingly, PD and CVRF do not seem to have any impact on the short-term outcome of TTS patients.
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Affiliation(s)
- Roya Anahita Mousavi
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute for Cardiovascular and Critical Care Research, Vienna, Austria
| | - Andreas Schober
- Karl Landsteiner Institute for Cardiovascular and Critical Care Research, Vienna, Austria
- Department of Cardiology, Clinic Floridsdorf, Vienna, Austria
| | | | - Emilie Han
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Brigitte Litschauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Gernot Pichler
- Karl Landsteiner Institute for Cardiovascular and Critical Care Research, Vienna, Austria
- Department of Cardiology, Clinic Floridsdorf, Vienna, Austria
| | - Roza Badr Eslam
- Department of Cardiology, Medical University of Vienna, Vienna, Austria.
- Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Zweiker D, Pogran E, Gargiulo L, Abd El-Razek A, Lechner I, Vosko I, Rechberger S, Bugger H, Christ G, Bonderman D, Kunschitz E, Czedik-Eysenberg C, Roithinger A, Weihs V, Kaufmann CC, Zirlik A, Bauer A, Metzler B, Lambert T, Steinwender C, Huber K. Neutrophile-Lymphocyte Ratio and Outcome in Takotsubo Syndrome. BIOLOGY 2022; 11:biology11081154. [PMID: 36009781 PMCID: PMC9404721 DOI: 10.3390/biology11081154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022]
Abstract
Background: Takotsubo syndrome (TTS) is an important type of acute heart failure with significant risk of acute complications and death. In this analysis we sought to identify predictors for in-hospital clinical outcome in TTS patients and present long-term outcomes. Methods: In this analysis from the Austrian national TTS registry, univariable and multivariable analyses were performed to identify significant predictors for severe in-hospital complications requiring immediate invasive treatment or leading to irreversible damage, such as cardiogenic shock, intubation, stroke, arrhythmias and death. Furthermore, the influence of independent predictors on long-term survival was evaluated. Results: A total of 338 patients (median age 72 years, 86.9% female) from six centers were included. Severe in-hospital complications occurred in 14.5% of patients. In multivariable analysis, high neutrophile-lymphocyte-ratio (NLR; OR 1.04 [95% CI 1.02−1.07], p = 0.009) and low LVEF (OR 0.92 [0.90−0.95] per %, p < 0.001) were significant predictors of severe in-hospital complications. Both the highest NLR tercile and the lowest LVEF tercile were significantly associated with reduced 5-year survival. Conclusions: Low LVEF and high NLR at admission were independently associated with increased in-hospital complications and reduced long-term survival in TTS patients. NLR is a new easy-to-measure tool to predict worse short- and long-term outcome after TTS.
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Affiliation(s)
- David Zweiker
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), 1160 Vienna, Austria; (E.P.); (V.W.); (C.C.K.); (K.H.)
- Department of Cardiology, Medical University of Graz, 8036 Graz, Austria; (I.V.); (H.B.); (A.Z.)
- Correspondence: ; Tel.: +43-664-8650460; Fax: +43-1-49150-2309
| | - Edita Pogran
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), 1160 Vienna, Austria; (E.P.); (V.W.); (C.C.K.); (K.H.)
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria; (L.G.); (A.A.E.-R.); (A.R.)
| | - Laura Gargiulo
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria; (L.G.); (A.A.E.-R.); (A.R.)
| | - Ahmed Abd El-Razek
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria; (L.G.); (A.A.E.-R.); (A.R.)
| | - Ivan Lechner
- Clinic of Internal Medicine III—Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (I.L.); (A.B.); (B.M.)
| | - Ivan Vosko
- Department of Cardiology, Medical University of Graz, 8036 Graz, Austria; (I.V.); (H.B.); (A.Z.)
| | - Stefan Rechberger
- Department of Cardiology and Intensive Medicine, Kepler University Clinic, 4020 Linz, Austria; (S.R.); (T.L.); (C.S.)
| | - Heiko Bugger
- Department of Cardiology, Medical University of Graz, 8036 Graz, Austria; (I.V.); (H.B.); (A.Z.)
| | - Günter Christ
- 5th Medical Department for Cardiology, Clinic Favoriten, 1100 Vienna, Austria; (G.C.); (D.B.)
| | - Diana Bonderman
- 5th Medical Department for Cardiology, Clinic Favoriten, 1100 Vienna, Austria; (G.C.); (D.B.)
| | | | | | - Antonia Roithinger
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria; (L.G.); (A.A.E.-R.); (A.R.)
| | - Valerie Weihs
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), 1160 Vienna, Austria; (E.P.); (V.W.); (C.C.K.); (K.H.)
- Core Facility, Medical University of Vienna, 1090 Vienna, Austria;
| | - Christoph C. Kaufmann
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), 1160 Vienna, Austria; (E.P.); (V.W.); (C.C.K.); (K.H.)
| | - Andreas Zirlik
- Department of Cardiology, Medical University of Graz, 8036 Graz, Austria; (I.V.); (H.B.); (A.Z.)
| | - Axel Bauer
- Clinic of Internal Medicine III—Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (I.L.); (A.B.); (B.M.)
| | - Bernhard Metzler
- Clinic of Internal Medicine III—Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (I.L.); (A.B.); (B.M.)
| | - Thomas Lambert
- Department of Cardiology and Intensive Medicine, Kepler University Clinic, 4020 Linz, Austria; (S.R.); (T.L.); (C.S.)
| | - Clemens Steinwender
- Department of Cardiology and Intensive Medicine, Kepler University Clinic, 4020 Linz, Austria; (S.R.); (T.L.); (C.S.)
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), 1160 Vienna, Austria; (E.P.); (V.W.); (C.C.K.); (K.H.)
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria; (L.G.); (A.A.E.-R.); (A.R.)
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Stöllberger C, Winkler-Dworak M, Schneider B. Refinement of data is needed concerning the long-term prognosis of patients with takotsubo syndrome. Wien Klin Wochenschr 2022; 134:675-676. [PMID: 35318514 DOI: 10.1007/s00508-022-02019-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Claudia Stöllberger
- Office Wehlistraße, Vienna, Austria. .,, Steingasse 31/18, 1030, Wien, Austria.
| | - Maria Winkler-Dworak
- Vienna Institute of Demography, Wittgenstein Centre for Demography and Global Human Capital, Vienna, Austria
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