Mechanical circulatory support for cardiogenic shock in takotsubo syndrome
Status Publisher Jazyk angličtina Země Německo Médium print-electronic
Typ dokumentu časopisecké články
PubMed
41627440
DOI
10.1007/s00392-025-02832-z
PII: 10.1007/s00392-025-02832-z
Knihovny.cz E-zdroje
- Klíčová slova
- Cardiogenic shock, Mechanical circulatory support, Mortality, Takotsubo syndrome,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Cardiogenic shock complicates takotsubo syndrome (TTS) in approximately 10% of cases. The effectiveness of mechanical circulatory support (MCS) for managing cardiogenic shock in TTS remains unknown. METHODS: We assessed outcomes in TTS patients with cardiogenic shock who received MCS compared to medical therapy only by using data from the International Takotsubo Registry. Two independent propensity scores were computed to investigate outcomes of patients with an intra-aortic balloon pump (IABP) vs. medical therapy only (1:2 propensity score matched cohort) and patients with an Impella vs. medical therapy only (1:1 propensity score matched cohort). The primary endpoint was in-hospital mortality and the secondary outcomes included MCS-related complications. RESULTS: Among 3740 eligible patients, 309 (8.3%) patients had cardiogenic shock, of whom 112 (36.2%) had MCS and 197 (63.8%) had medical therapy only. After propensity-score matching, the use of an IABP was found to be associated with a lower in-hospital mortality rate than medical therapy only (14.5% vs. 35.5%, P = 0.002), while mortality rates in the Impella group and medical therapy only group were comparable (25.0% vs. 29.2%, P = 0.75). MCS-related complications occurred in 6.0% of the IABP cohort and in 31.3% of Impella cohort. CONCLUSION: Active MCS has been increasingly used for the management of cardiogenic shock in patients with TTS. This observational study could not demonstrate an association with improved mortality with an Impella device, but possibly with an IABP when compared to patients with medical management only. MCS-related complications occurred more frequently in the Impella cohort than in the IABP cohort. Further data are required to confirm results of the present study.
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 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 Charité Campus Rudolf Virchow Berlin Germany
Department of Cardiology Chiba Emergency Medical Center Chiba Japan
Department of Cardiology Christchurch Hospital Christchurch New Zealand
Department of Cardiology E P E Centro Hospitalar Universitário de São João Porto Portugal
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 Technische Universität München Deutsches Herzzentrum München Munich Germany
Department of Cardiology University Hospital Basel Basel Switzerland
Department of Cardiology University Medical Center Mainz Mainz Germany
Department of Cardiovascular Diseases Mayo Clinic Rochester MN 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 3 Heart Center University of Cologne Cologne Germany
Department of Internal Medicine Cardiology and Angiology Magdeburg University Magdeburg Germany
Department of Medicine Surgery and Dentistry University of Salerno Baronissi Salerno Italy
Department of Vascular Physiopathology IRCCS Neuromed Pozzilli Italy
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 IA 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 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
Intensive Coronary Care Unit Named After N Pirogov Moscow City Hospital 1 Moscow Russia
Keck School of Medicine University of Southern California Los Angeles CA USA
Klinik Für Innere Medizin 3 Universitätsklinikum Des Saarlandes HomburgSaar 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 Arzignano Vicenza Italy
Marien Hospital Herne Ruhr University Bochum Herne Germany
Medical Center University of Ulm Ulm Germany
Medicine Campus Davos Davos Switzerland
Royal Brompton and Harefield Hospitals Trust Imperial College and King's College London UK
Service de Cardiologie Hôpitaux Universitaires de Genève Geneva Switzerland
Städtisches Klinikum Dresden Klinik Für Kardiologie Dresden Germany
Structural Interventional Cardiology Careggi University Hospital Florence Italy
SwissCardioVascular Clinic Private Hospital Bethanien Zurich Switzerland
TJ Health Partners Heart and Vascular Glasgow KY USA
University Hospital for Internal Medicine 3 Medical University Innsbruck Innsbruck Austria
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