TY - JOUR
T1 - Incidence and Clinical Impact of Recurrent Takotsubo Syndrome: Results From the GEIST Registry
AU - El-Battrawy, Ibrahim
AU - Santoro, Francesco
AU - Stiermaier, Thomas
AU - Möller, Christian
AU - Guastafierro, Francesca
AU - Novo, Giuseppina
AU - Novo, Salvatore
AU - Mariano, Enrica
AU - Romeo, Francesco
AU - Romeo, Fabiana
AU - Thiele, Holger
AU - Guerra, Federico
AU - Capucci, Alessandro
AU - Giannini, Irene
AU - Brunetti, Natale Daniele
AU - Eitel, Ingo
AU - Akin, Ibrahim
PY - 2019/5/7
Y1 - 2019/5/7
N2 - Background: Current literature only reports variable information from single-center studies on the recurrence rate, the complications, and the outcome of patients with Takotsubo syndrome (TTS) experiencing recurrent TTS. Therefore, a detailed description of clinical characteristics, predictors, and the prognostic impact of patients with TTS and recurrences in a multicenter registry is needed. Methods and Results: We analyzed 749 patients with TTS from 9 European centers being part of the international, multicenter GEIST (German Italian Stress Cardiomyopathy) Registry. Patients were divided into the recurrence group and the nonrecurrence group. The recurrence rate at a median follow-up of 830 days (interquartile range, 118–1701 days) was 4%. Most recurrences were documented in the first 5 years after the index TTS episode. Up to 2 TTS recurrences were documented in 2 of 30 patients (6%). A variable ballooning pattern (n=6, 0.8%) with, in particular, involvement of the right ventricular occurred in 3 cases (0.4%) at the recurrence event. Except for the higher presence of arterial hypertension (86.7% versus 68.3%; P=0.03) in the recurrence group, no other baseline characteristics were different between groups. Observation of TTS complications during follow-up, including stroke, thromboembolic events, in-hospital death, and cardiogenic shock, revealed no significant differences between groups (P>0.05), except the higher presence of pulmonary edema in the recurrence group versus the nonrecurrence group (13.3% versus 4.9%; P=0.04). Conclusions: The incidence of TTS recurrence is estimated to be 4% in this multicenter TTS registry. A variable TTS pattern at recurrence is common in up to 20% of recurrence cases.
AB - Background: Current literature only reports variable information from single-center studies on the recurrence rate, the complications, and the outcome of patients with Takotsubo syndrome (TTS) experiencing recurrent TTS. Therefore, a detailed description of clinical characteristics, predictors, and the prognostic impact of patients with TTS and recurrences in a multicenter registry is needed. Methods and Results: We analyzed 749 patients with TTS from 9 European centers being part of the international, multicenter GEIST (German Italian Stress Cardiomyopathy) Registry. Patients were divided into the recurrence group and the nonrecurrence group. The recurrence rate at a median follow-up of 830 days (interquartile range, 118–1701 days) was 4%. Most recurrences were documented in the first 5 years after the index TTS episode. Up to 2 TTS recurrences were documented in 2 of 30 patients (6%). A variable ballooning pattern (n=6, 0.8%) with, in particular, involvement of the right ventricular occurred in 3 cases (0.4%) at the recurrence event. Except for the higher presence of arterial hypertension (86.7% versus 68.3%; P=0.03) in the recurrence group, no other baseline characteristics were different between groups. Observation of TTS complications during follow-up, including stroke, thromboembolic events, in-hospital death, and cardiogenic shock, revealed no significant differences between groups (P>0.05), except the higher presence of pulmonary edema in the recurrence group versus the nonrecurrence group (13.3% versus 4.9%; P=0.04). Conclusions: The incidence of TTS recurrence is estimated to be 4% in this multicenter TTS registry. A variable TTS pattern at recurrence is common in up to 20% of recurrence cases.
UR - http://www.scopus.com/inward/record.url?scp=85065585919&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/incidence-clinical-impact-recurrent-takotsubo-syndrome-results-geist-registry
U2 - 10.1161/JAHA.118.010753
DO - 10.1161/JAHA.118.010753
M3 - Journal articles
C2 - 31046506
AN - SCOPUS:85065585919
SN - 2047-9980
VL - 8
SP - e010753
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 9
M1 - e010753
ER -