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Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry

VL. Cammann, A. Sarcon, KJ. Ding, B. Seifert, K. Kato, D. Di Vece, KA. Szawan, S. Gili, S. Jurisic, B. Bacchi, J. Micek, AH. Frangieh, LC. Napp, M. Jaguszewski, E. Bossone, R. Citro, F. D'Ascenzo, J. Franke, M. Noutsias, M. Knorr, S. Heiner, C....

. 2019 ; 8 (15) : e010881. [pub] 20190717

Jazyk angličtina Země Velká Británie

Typ dokumentu srovnávací studie, časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc21013015

Background Clinical characteristics and outcomes of takotsubo syndrome (TTS) patients with malignancy have not been fully elucidated. This study sought to explore differences in clinical characteristics and to investigate short- and long-term outcomes in TTS patients with or without malignancy. Methods and Results TTS patients were enrolled from the International Takotsubo Registry. The TTS cohort was divided into patients with and without malignancy to investigate differences in clinical characteristics and to assess short- and long-term mortality. A subanalysis was performed comparing long-term mortality between a subset of TTS patients with or without malignancy and acute coronary syndrome (ACS) patients with or without malignancy. Malignancy was observed in 16.6% of 1604 TTS patients. Patients with malignancy were older and more likely to have physical triggers, but less likely to have emotional triggers compared with those without malignancy. Long-term mortality was higher in patients with malignancy (P<0.001), while short-term outcome was comparable (P=0.17). In a subanalysis, long-term mortality was comparable between TTS patients with malignancies and ACS patients with malignancies (P=0.13). Malignancy emerged as an independent predictor of long-term mortality. Conclusions A substantial number of TTS patients show an association with malignancy. History of malignancy might increase the risk for TTS, and therefore, appropriate screening for malignancy should be considered in these patients. Clinical Trial Registration URL: http://www.clinicaltrial.gov. Unique identifier: NCT01947621.

1st Department of Cardiology Medical University of Gdansk Poland

1st Department of Medicine Faculty of Medicine University Medical Centre Mannheim University of Heidelberg Mannheim Germany

Cardiology 1 Center for Cardiology University Medical Center Mainz Mainz Germany

Cardiology Royal Brompton and Harefield Hospital and Imperial College London United Kingdom

Center for Molecular Cardiology Schlieren Campus University of Zurich Zurich Switzerland

Centro Cardiologico Monzino IRCCS Milan Italy

Charles University Prague and University Hospital Kralovske Vinohrady Prague Czech Republic

Clinic for Cardiology and Pneumology Georg August University Goettingen Goettingen Germany

Department of Cardiology and Angiology Hannover Medical School Hannover Germany

Department of Cardiology and Cardiac Imaging Center University Hospital of Rangueil Toulouse France

Department of Cardiology Basil Hetzel Institute Queen Elizabeth Hospital University of Adelaide Australia

Department of Cardiology Charité Campus Rudolf Virchow Berlin Germany

Department of Cardiology Heidelberg University Hospital Heidelberg Germany

Department of Cardiology John Radcliffe Hospital Oxford University Hospitals Oxford United Kingdom

Department of Cardiology Kantonsspital Lucerne Lucerne Switzerland

Department of Cardiology Kantonsspital Winterthur Winterthur Switzerland

Department of Cardiology Kings College Hospital Kings Health Partners London United Kingdom

Department of Cardiology Leiden University Medical Centre Leiden The Netherlands

Department of Cardiology Medical University of Warsaw Poland

Department of Cardiology University Hospital Basel Basel Switzerland

Department of General and Interventional Cardiology University Heart Center Hamburg Hamburg Germany

Department of Internal Medicine 2 Cardiology University of Ulm Medical Center Ulm Germany

Department of Internal Medicine 3 Heart Center University of Cologne Germany

Department of Internal Medicine B University Medicine Greifswald Greifswald Germany

Department of Internal Medicine Cardiology Heart Center Leipzig University Hospital Leipzig Germany

Department of Medicine College of Medicine University of Florida Gainesville FL

Deutsches Herzzentrum München Technische Universität München Munich Germany

Division of Biostatistics Epidemiology Biostatistics and Prevention Institute University of Zurich Switzerland

Division of Cardiology Angiology and Intensive Medical Care Department of Internal Medicine 3 University Hospital Halle Martin Luther University Halle Halle Germany

Division of Cardiology Department of Medical Sciences AOU Città della Salute e della Scienza University of Turin Italy

Division of Cardiovascular Diseases Mayo Clinic Rochester MN

DZHK partner site Greifswald Greifswald Germany

DZHK partner site Hamburg Kiel Luebeck Hamburg Germany

DZHK partner site Heidelberg Mannheim Mannheim Germany

DZHK partner site Munich Heart Alliance Munich Germany

Fondazione Policlinico Universitario A Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy

Heart and Vascular Centre Bad Bevensen Bad Bevensen Germany

Heart Center Turku University Hospital and University of Turku Finland

Heart Department University Hospital San Giovanni di Dio e Ruggi d'Aragona Salerno Italy

Intensive coronary care Unit Moscow City Hospital 1 named after N Pirogov Moscow Russia

Internal Medicine Cardiology Angiology and Pneumology Magdeburg University Magdeburg Germany

Klinik für Innere Medizin 3 Universitätsklinikum des Saarlandes Homburg Saar Germany

Krankenhaus Maria Hilf Medizinische Klinik Stadtlohn Germany

Structural Interventional Cardiology Careggi University Hospital Florence Italy

TJ Health Partners Heart and Vascular Glasgow Kentucky

University Heart Center Department of Cardiology University Hospital Zurich Zurich Switzerland

University Hospital for Internal Medicine 3 Medical University Innsbruck Innsbruck Austria

University of Southern California Keck School of Medicine Los Angeles CA

Citace poskytuje Crossref.org

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$a Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry / $c VL. Cammann, A. Sarcon, KJ. Ding, B. Seifert, K. Kato, D. Di Vece, KA. Szawan, S. Gili, S. Jurisic, B. Bacchi, J. Micek, AH. Frangieh, LC. Napp, M. Jaguszewski, E. Bossone, R. Citro, F. D'Ascenzo, J. Franke, M. Noutsias, M. Knorr, S. Heiner, C. Burgdorf, W. Koenig, H. Thiele, C. Tschöpe, L. Rajan, G. Michels, R. Pfister, A. Cuneo, C. Jacobshagen, M. Karakas, A. Banning, F. Cuculi, R. Kobza, TA. Fischer, T. Vasankari, KEJ. Airaksinen, R. Dworakowski, C. Kaiser, S. Osswald, L. Galiuto, W. Dichtl, C. Delmas, O. Lairez, JD. Horowitz, M. Kozel, P. Widimský, P. Tousek, DE. Winchester, E. Gilyarova, A. Shilova, M. Gilyarov, I. El-Battrawy, I. Akin, C. Ukena, J. Bauersachs, BM. Pieske, G. Hasenfuß, W. Rottbauer, RC. Braun-Dullaeus, G. Opolski, P. MacCarthy, SB. Felix, M. Borggrefe, C. Di Mario, F. Crea, HA. Katus, H. Schunkert, T. Münzel, M. Böhm, JJ. Bax, A. Prasad, J. Shinbane, TF. Lüscher, F. Ruschitzka, JR. Ghadri, C. Templin
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$a Background Clinical characteristics and outcomes of takotsubo syndrome (TTS) patients with malignancy have not been fully elucidated. This study sought to explore differences in clinical characteristics and to investigate short- and long-term outcomes in TTS patients with or without malignancy. Methods and Results TTS patients were enrolled from the International Takotsubo Registry. The TTS cohort was divided into patients with and without malignancy to investigate differences in clinical characteristics and to assess short- and long-term mortality. A subanalysis was performed comparing long-term mortality between a subset of TTS patients with or without malignancy and acute coronary syndrome (ACS) patients with or without malignancy. Malignancy was observed in 16.6% of 1604 TTS patients. Patients with malignancy were older and more likely to have physical triggers, but less likely to have emotional triggers compared with those without malignancy. Long-term mortality was higher in patients with malignancy (P<0.001), while short-term outcome was comparable (P=0.17). In a subanalysis, long-term mortality was comparable between TTS patients with malignancies and ACS patients with malignancies (P=0.13). Malignancy emerged as an independent predictor of long-term mortality. Conclusions A substantial number of TTS patients show an association with malignancy. History of malignancy might increase the risk for TTS, and therefore, appropriate screening for malignancy should be considered in these patients. Clinical Trial Registration URL: http://www.clinicaltrial.gov. Unique identifier: NCT01947621.
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