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Cardiac troponin elevation and mortality in takotsubo syndrome: New insights from the international takotsubo registry
BE. Stähli, M. Schindler, V. Schweiger, VL. Cammann, KA. Szawan, D. Niederseer, M. Würdinger, A. Schönberger, M. Schönberger, I. Koleva, JC. Mercier, V. Petkova, S. Mayer, R. Citro, C. Vecchione, E. Bossone, S. Gili, M. Neuhaus, J. Franke, B....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
Grantová podpora
Abbott Vascular
Biotronik
NA
Iten-Kohaut Foundation
Medtronic Foundation
MicroPort
SMT
NA
Deutsches Zentrum für Herz-Kreislaufforschung
Biss Davies Charitable Trust
Edwards Lifesciences
Schnell Medical
Boston Scientific Corporation
NA
swiss national foundation
PubMed
39397275
DOI
10.1111/eci.14317
Knihovny.cz E-zdroje
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- registrace * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- takotsubo kardiomyopatie * krev mortalita MeSH
- troponin I krev MeSH
- troponin T * krev MeSH
- troponin krev metabolismus MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The clinical relevance of cardiac troponin (cTn) elevation in takotsubo syndrome (TTS) remains uncertain. The present study sought to investigate the role of cardiac troponin (cTn) elevations in mortality prediction of patients with Takotsubo syndrome (TTS). METHODS: Patients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to February 2020 with available data on peak cTn levels were included in the analysis. Peak cTn levels during the index hospitalization were used to define clinically relevant myocardial injury. The threshold at which clinically relevant myocardial injury drives mortality at 1 year was identified using restricted cubic spline analysis. RESULTS: Out of 2'938 patients, 222 (7.6%) patients died during 1-year follow-up. A more than 28.8-fold increase of cTn above the upper reference limit was identified as threshold for clinically relevant myocardial injury. The presence of clinically relevant myocardial injury was significantly associated with an increased risk of mortality at 5 years (adjusted HR 1.58, 95% CI 1.18-2.12, p =.002). Clinically relevant myocardial injury was related to an increased 5-year mortality risk in patients with apical TTS (adjusted HR 1.57, 95% CI 1.21-2.03, p =.001), in presence of physical stressors (adjusted HR 1.60, 95% CI 1.22-2.11, p =.001), and in absence of emotional stressors (adjusted HR 1.49, 95% CI, 1.17-1.89, p =.001). CONCLUSION: This study for the first time determined a troponin threshold for the identification of TTS patients at excess risk of mortality. These findings advance risk stratification in TTS and assist in identifying patients in need for close monitoring and follow-up.
1st Clinic of Internal Medicine Department of Internal Medicine University of Genoa Genoa Italy
1st Department of Cardiology Medical University of Gdansk Gdansk Poland
Berlin Institute of Health Berlin Germany
Center for Cardiology Cardiology 1 University Medical Center Mainz Mainz Germany
Center for Molecular Cardiology Schlieren Campus University of Zurich Zurich Switzerland
Center of Translational and Experimental Cardiology University Hospital Zurich Zurich Switzerland
Centro cardiologico Monzino IRCCS Milan Italy
Christine Kühne Center for Allergy Research and Education Medicine Campus Davos Davos Switzerland
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 and Internal Medicine B University Medicine Greifswald Germany
Department of Cardiology Centro Hospitalar Universitário de São João E P E Porto Portugal
Department of Cardiology Chiba Emergency Medical Center Chiba Japan
Department of Cardiology Christchurch Hospital Christchurch New Zealand
Department of Cardiology Heidelberg University Hospital Heidelberg Germany
Department of Cardiology John Radcliffe Hospital Oxford University Hospitals Oxford UK
Department of Cardiology Kantonsspital Frauenfeld Frauenfeld Switzerland
Department of Cardiology Kantonsspital Lucerne Lucerne Switzerland
Department of Cardiology Kantonsspital St Gallen St Gallen Switzerland
Department of Cardiology Kantonsspital Winterthur Winterthur Switzerland
Department of Cardiology King's College Hospital London UK
Department of Cardiology Leiden University Medical Centre Leiden The Netherlands
Department of Cardiology Medical University of Warsaw Warsaw Poland
Department of Cardiology National University Heart Centre Singapore Singapore
Department of Cardiology University Hospital Basel Basel Switzerland
Department of Cardiovascular Diseases Mayo Clinic Rochester Minnesota USA
Department of Cardiovascular Medicine Chiba University Graduate School of Medicine Chiba Japan
Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan
Department of Intensive Care Medicine University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Internal Medicine 1 Cardiology University Hospital Olomouc Olomouc Czech Republic
Department of Internal Medicine 2 Cardiology University of Ulm Medical Center Ulm Germany
Department of Internal Medicine 3 Heart Center University of Cologne Cologne Germany
Department of Internal Medicine Cardiology and Angiology Magdeburg University Magdeburg Germany
Department of Internal Medicine Cardiology Heart Center Leipzig University Hospital Leipzig Germany
Department of Medicine Surgery and Dentistry University of Salerno Salerno Italy
Deutsches Herzzentrum München Technische Universität München Munich Germany
Division of Cardiology A O U San Luigi Gonzaga Orbassano Turin Italy
Division of Cardiology Antonio Cardarelli Hospital Naples Italy
Division of Cardiology Heart and Vascular Center University of Iowa Iowa City Iowa USA
Division of Cardiology Kimitsu Central Hospital Kisarazu Japan
Division of Cardiology Medical University of Graz Graz Austria
Dorset Heart Centre Royal Bournemouth Hospital Bournemouth UK
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 Turku Finland
Heart Department University Hospital San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
Hochgebirgsklinik Medicine Campus Davos Davos Switzerland
Intensive Coronary Care Unit Moscow City Hospital 1 named after N Pirogov Moscow Russia
IRCCS Ospedale Policlinico San Martino Genoa Italian Cardiovascular Network Genoa Italy
Klinik für Innere Medizin 3 Universitätsklinikum des Saarlandes Homburg Saar Germany
Klinik und Poliklinik für Innere Medizin 2 Universitätsklinikum Regensburg Regensburg Germany
Krankenhaus Maria Hilf Medizinische Klinik Stadtlohn Germany
Local Health Unit n 8 Cardiology Unit Vicenza Italy
Royal Brompton and Harefield Hospitals Trust and Imperial College London UK
Service de Cardiologie Hôpitaux Universitaires de Genève Geneva Switzerland
Structural Interventional Cardiology Careggi University Hospital Florence Italy
TJ Health Partners Heart and Vascular Glasgow Kentucky USA
University Hospital for Internal Medicine 3 Medical University Innsbruck Innsbruck Austria
University of Southern California Keck School of Medicine Los Angeles California USA
Citace poskytuje Crossref.org
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- $a Cardiac troponin elevation and mortality in takotsubo syndrome: New insights from the international takotsubo registry / $c BE. Stähli, M. Schindler, V. Schweiger, VL. Cammann, KA. Szawan, D. Niederseer, M. Würdinger, A. Schönberger, M. Schönberger, I. Koleva, JC. Mercier, V. Petkova, S. Mayer, R. Citro, C. Vecchione, E. Bossone, S. Gili, M. Neuhaus, J. Franke, B. Meder, M. Jaguszewski, M. Noutsias, M. Knorr, T. Jansen, F. D'Ascenzo, W. Dichtl, D. von Lewinski, C. Burgdorf, B. Kherad, C. Tschöpe, A. Sarcon, J. Shinbane, L. Rajan, G. Michels, R. Pfister, A. Cuneo, C. Jacobshagen, M. Karakas, W. Koenig, A. Pott, P. Meyer, M. Roffi, A. Banning, M. Wolfrum, F. Cuculi, R. Kobza, TA. Fischer, T. Vasankari, KEJ. Airaksinen, LC. Napp, R. Dworakowski, P. MacCarthy, C. Kaiser, S. Osswald, L. Galiuto, C. Chan, P. Bridgman, D. Beug, C. Delmas, O. Lairez, E. Gilyarova, A. Shilova, M. Gilyarov, I. El-Battrawy, I. Akin, K. Poledniková, P. Toušek, DE. Winchester, M. Massoomi, J. Galuszka, C. Ukena, G. Poglajen, P. Carrilho-Ferreira, C. Hauck, C. Paolini, C. Bilato, Y. Kobayashi, K. Kato, I. Ishibashi, T. Himi, J. Din, A. Al-Shammari, A. Prasad, CS. Rihal, K. Liu, PC. Schulze, M. Bianco, L. Jörg, H. Rickli, G. Pestana, TH. Nguyen, M. Böhm, LS. Maier, FJ. Pinto, P. Widimský, SB. Felix, RC. Braun-Dullaeus, W. Rottbauer, G. Hasenfuß, BM. Pieske, H. Schunkert, M. Budnik, G. Opolski, H. Thiele, J. Bauersachs, JD. Horowitz, C. Di Mario, W. Kong, M. Dalakoti, Y. Imori, L. Liberale, F. Montecucco, T. Münzel, F. Crea, TF. Lüscher, JJ. Bax, F. Ruschitzka, JR. Ghadri, D. Di Vece, C. Templin
- 520 9_
- $a BACKGROUND: The clinical relevance of cardiac troponin (cTn) elevation in takotsubo syndrome (TTS) remains uncertain. The present study sought to investigate the role of cardiac troponin (cTn) elevations in mortality prediction of patients with Takotsubo syndrome (TTS). METHODS: Patients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to February 2020 with available data on peak cTn levels were included in the analysis. Peak cTn levels during the index hospitalization were used to define clinically relevant myocardial injury. The threshold at which clinically relevant myocardial injury drives mortality at 1 year was identified using restricted cubic spline analysis. RESULTS: Out of 2'938 patients, 222 (7.6%) patients died during 1-year follow-up. A more than 28.8-fold increase of cTn above the upper reference limit was identified as threshold for clinically relevant myocardial injury. The presence of clinically relevant myocardial injury was significantly associated with an increased risk of mortality at 5 years (adjusted HR 1.58, 95% CI 1.18-2.12, p =.002). Clinically relevant myocardial injury was related to an increased 5-year mortality risk in patients with apical TTS (adjusted HR 1.57, 95% CI 1.21-2.03, p =.001), in presence of physical stressors (adjusted HR 1.60, 95% CI 1.22-2.11, p =.001), and in absence of emotional stressors (adjusted HR 1.49, 95% CI, 1.17-1.89, p =.001). CONCLUSION: This study for the first time determined a troponin threshold for the identification of TTS patients at excess risk of mortality. These findings advance risk stratification in TTS and assist in identifying patients in need for close monitoring and follow-up.
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