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Scientific article
English

Age-related variations in Takotsubo Syndrome

ContributorsCammann, 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; 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; 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; Ruschitzka, Frank; Ghadri, Jelena R; Opolski, Grzegorz; Templin, Christian
Published inJournal of the American College of Cardiology, vol. 75, no. 16, p. 1869-1877
Publication date2020-04-28
Abstract

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 = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 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 = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 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.

Keywords: Takotsubo syndrome; age; broken heart syndrome; outcome.

eng
Keywords
  • Takotsubo syndrome
  • Age
  • Broken heart syndrome
  • Outcome
  • Age Factors
  • Age of Onset
  • Aged
  • Causality
  • Female
  • Global Health
  • Hospital Mortality
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Mortality
  • Nervous System Diseases / epidemiology
  • Prevalence
  • Prognosis
  • Registries
  • Risk Assessment / statistics & numerical data
  • Shock, Cardiogenic / epidemiology
  • Shock, Cardiogenic / etiology
  • Takotsubo Cardiomyopathy / complications
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / epidemiology
  • Takotsubo Cardiomyopathy / physiopathology
Funding
  • European Commission - In Silico trials for drug tracing the effects of sarcomeric protein mutations leading to familial cardiomyopathy [777204]
Citation (ISO format)
CAMMANN, Victoria L et al. Age-related variations in Takotsubo Syndrome. In: Journal of the American College of Cardiology, 2020, vol. 75, n° 16, p. 1869–1877. doi: 10.1016/j.jacc.2020.02.057
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Article (Published version)
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ISSN of the journal0735-1097
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