Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry
: Victoria L. Cammann, Annahita Sarcon, Katharina J. Ding, Burkhardt Seifert, Ken Kato, Davide Di Vece, Konrad A. zawan, Sebastiano Gili, Stjepan Jurisic, Beatrice Bacchi, Jozef Micek, Antonio H. Frangieh, L. Christian Napp, Milosz Jaguszewski, Eduardo Bossone, Rodolfo Citro, Fabrizio D'Ascenzo, Jennifer Franke, Michel Noutsias, Maike Knorr, Susanne Heiner, Christof Burgdorf, Wolfgang Koenig, Holger Thiele, Carsten Tschöpe, Lawrence Rajan, Guido ichels, Roman Pfister, Alessandro Cuneo, Claudius Jacobshagen, Mahir Karakas, Adrian Banning, Florim Cuculi, Richard Kobza, Thomas A. Fischer, Tuija Vasankari, K. E. Juhani Airaksinen, Rafal Dworakowski, Christoph Kaiser, Stefan Osswald, Leonarda Galiuto, Wolfgang Dichtl, Clément Delmas, Olivier Lairez, John D. Horowitz, Martin Kozel, Petr Widimský, Petr Tousek, David E. Winchester, Ekaterina Gilyarova, Alexandra Shilova, Mikhail Gilyarov, Ibrahim El‐Battrawy, Ibrahim Akin, Christian Ukena, Johann Bauersachs, Burkert M. Pieske, Gerd Hasenfuß, Wolfgang Rottbauer, Ruediger C. Braun‐Dullaeus, Grzegorz Opolski, Philip MacCarthy, Stephan B. Felix, Martin Borggrefe, Carlo Di Mario, Filippo Crea, Hugo A. Katus, Heribert Schunkert, Thomas Münzel, Michael Böhm, Jeroen J. Bax, Abhiram Prasad, Jerold Shinbane, Thomas F. Lüscher, Frank Ruschitzka, Jelena R. Ghadri, and Christian Templin
Publisher: American Heart Association
: 2019
: Journal of the American Heart Association
: JAHA
: 8
: 15
: 13
: 2047-9980
: 2047-9980
DOI: https://doi.org/10.1161/JAHA.118.010881
: https://research.utu.fi/converis/portal/detail/Publication/42533864
Background
Clinical characteristics and outcomes of takotsubo syndrome (TTS)
patients with malignancy have not been fully elucidated. This study
sought to explore differences in clinical characteristics and to
investigate short‐ and long‐term outcomes in TTS patients with or without malignancy.
TTS patients were enrolled from the International Takotsubo Registry. The TTS
cohort was divided into patients with and without malignancy to
investigate differences in clinical characteristics and to assess short‐
and long‐term mortality. A subanalysis was performed comparing
long‐term mortality between a subset of TTS
patients with or without malignancy and acute coronary syndrome (ACS)
patients with or without malignancy. Malignancy was observed in 16.6% of
1604 TTS
patients. Patients with malignancy were older and more likely to have
physical triggers, but less likely to have emotional triggers compared
with those without malignancy. Long‐term mortality was higher in
patients with malignancy (P<0.001), while short‐term outcome was comparable (P=0.17). In a subanalysis, long‐term mortality was comparable between TTS patients with malignancies and ACS patients with malignancies (P=0.13). Malignancy emerged as an independent predictor of long‐term mortality.
A substantial number of TTS patients show an association with malignancy. History of malignancy might increase the risk for TTS, and therefore, appropriate screening for malignancy should be considered in these patients.
