Smoking influence in Takotsubo syndrome: insights from an international cohort

Iván J. Núñez-Gil*, Francesco Santoro, Ravi Vazirani, Giuseppina Novo, Emilia Blanco-Ponce, Luca Arcari, Aitor Uribarri, Luca Cacciotti, Federico Guerra, Jorge Salamanca, Beatrice Musumeci, Oscar Vedia, Enrica Mariano, Clara Fernández-Cordón, Pasquale Caldarola, Roberta Montisci, Natale Daniele Brunetti, Ibrahim El-Battrawy, Mohammad Abumayyaleh, Ibrahim AkinIngo Eitel, Thomas Stiermaier

*Korrespondierende/r Autor/-in für diese Arbeit


Aims: To assess the influence of tobacco on acute and long-term outcomes in Takotsubo syndrome (TTS). Methods: Patients with TTS from the international multicenter German Italian Spanish Takotsubo registry (GEIST) were analyzed. Comparisons between groups were performed within the overall cohort, and an adjusted analysis with 1:1 propensity score matching was conducted. Results: Out of 3,152 patients with TTS, 534 (17%) were current smokers. Smoker TTS patients were younger (63 ± 11 vs. 72 ± 11 years, p < 0.001), less frequently women (78% vs. 90%, p < 0.001), and had a lower prevalence of hypertension (59% vs. 69%, p < 0.01) and diabetes mellitus (16% vs. 20%, p = 0.04), but had a higher prevalence of pulmonary (21% vs. 15%, p < 0.01) and/or psychiatric diseases (17% vs. 12%, p < 0.01). On multivariable analysis, age less than 65 years [OR 3.85, 95% CI (2.86–5)], male gender [OR 2.52, 95% CI (1.75–3.64)], history of pulmonary disease [OR 2.56, 95% CI (1.81–3.61)], coronary artery disease [OR 2.35, 95% CI (1.60–3.46)], and non-apical ballooning form [OR 1.47, 95% CI (1.02–2.13)] were associated with smoking status. Propensity score matching (PSM) 1:1 yielded 329 patients from each group. Smokers had a similar rate of in-hospital complications but longer in-hospital stays (10 vs. 9 days, p = 0.01). During long-term follow-up, there were no differences in mortality rates between smokers and non-smokers (5.6% vs. 6.9% yearly in the overall, p = 0.02, and 6.6%, vs. 7.2% yearly in the matched cohort, p = 0.97). Conclusions: Our findings suggest that smoking may influence the clinical presentation and course of TTS with longer in-hospital stays, but does not independently impact mortality.

ZeitschriftFrontiers in Cardiovascular Medicine
PublikationsstatusVeröffentlicht - 2023

Strategische Forschungsbereiche und Zentren

  • Zentren: Universitäres Herzzentrum Lübeck (UHZL)


  • 205-12 Kardiologie, Angiologie