Age-Related Variations in Takotsubo Syndrome

Publication

Age-Related Variations in Takotsubo Syndrome

Journal Paper/Review - Jan 28, 2020

Shilova Alexandra, 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, Kobayashi Yoshio, Bilato Claudio, Paolini Carla, Gilyarov Mikhail, El-Battrawy Ibrahim, Akin Ibrahim, Poledniková Karolina, Tousek Petr, Winchester David E, Galuszka Jan, Ukena Christian, Poglajen Gregor, Carrilho-Ferreira Pedro, Hauck Christian, Jörg Lucas, Rickli Hans, Bauersachs Johann, Katus Hugo A, Horowitz John D, di Mario Carlo, Münzel Thomas, Crea Filippo, Bax Jeroen J, Lüscher Thomas F, Ruschitzka Frank, Ghadri Jelena R, Opolski Grzegorz, Thiele Holger, Borggrefe Martin, Schunkert Heribert, Pestana Gonçalo, Nguyen Thanh H, Böhm Michael, Maier Lars S, Pinto Fausto J, Widimsky Petr, Felix Stephan B, Braun-Dullaeus Ruediger C, Rottbauer Wolfgang, Hasenfuß Gerd, Pieske Burkert M, Templin Christian, Gilyarova Ekaterina, Cammann Victoria L, Jaguszewski Miłosz, Noutsias Michel, Knorr Maike, Heiner Susanne, D'Ascenzo Fabrizio, Dichtl Wolfgang, Burgdorf Christof, Kherad Behrouz, Tschope Carsten, Sarcon Annahita, Shinbane Jerold, Meder Benjamin, Franke Jennifer, Neuhaus Michael, 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, Rajan Lawrence, Michels Guido, 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, Vasankari Tuija, Fischer Thomas A, Kobza Richard, Pfister Roman, Cuneo Alessandro, Jacobshagen Claudius, Karakas Mahir, Koenig Wolfgang, Pott Alexander, Meyer Philippe, Roffi Marco, Banning Adrian, Wolfrum Mathias, Cuculi Florim, Lairez Olivier

Citation

Shilova A, Shoji T, Ishibashi I, Takahara M, Himi T, Din J, Al-Shammari A, Prasad A, Rihal C, Liu K, Schulze P, Bianco M, Kobayashi Y, Bilato C, Paolini C, Gilyarov M, El-Battrawy I, Akin I, Poledniková K, Tousek P, Winchester D, Galuszka J, Ukena C, Poglajen G, Carrilho-Ferreira P, Hauck C, Jörg L, Rickli H, Bauersachs J, Katus H, Horowitz J, di Mario C, Münzel T, Crea F, Bax J, Lüscher T, Ruschitzka F, Ghadri J, Opolski G, Thiele H, Borggrefe M, Schunkert H, Pestana G, Nguyen T, Böhm M, Maier L, Pinto F, Widimsky P, Felix S, Braun-Dullaeus R, Rottbauer W, Hasenfuß G, Pieske B, Templin C, Gilyarova E, Cammann V, Jaguszewski M, Noutsias M, Knorr M, Heiner S, D'Ascenzo F, Dichtl W, Burgdorf C, Kherad B, Tschope C, Sarcon A, Shinbane J, Meder B, Franke J, Neuhaus M, Szawan K, Stähli B, Kato K, Budnik M, Wischnewsky M, Dreiding S, Levinson R, Di Vece D, Gili S, Citro R, Bossone E, Rajan L, Michels G, Airaksinen K, Napp L, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Chan C, Bridgman P, Beug D, Delmas C, Vasankari T, Fischer T, Kobza R, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Koenig W, Pott A, Meyer P, Roffi M, Banning A, Wolfrum M, Cuculi F, Lairez O. Age-Related Variations in Takotsubo Syndrome. J Am Coll Cardiol 2020; 75:1869-1877.

Type

Journal Paper/Review (English)

Journal

J Am Coll Cardiol 2020; 75

Publication Date

Jan 28, 2020

Issn Electronic

1558-3597

Pages

1869-1877

Brief description/objective

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.