Coexistence and outcome of coronary artery disease in Takotsubo syndrome

被引：56

作者：

Napp, L. Christian ^{[1
]}

Cammann, Victoria L. ^{[2
]}

Jaguszewski, Milosz ^{[3
]}

Szawan, Konrad A. ^{[2
]}

Wischnewsky, Manfred ^{[4
]}

Gili, Sebastiano ^{[5
]}

Knorr, Maike ^{[6
]}

Heiner, Susanne ^{[6
]}

Citro, Rodolfo ^{[7
]}

Bossone, Eduardo ^{[8
]}

D'Ascenzo, Fabrizio ^{[9
]}

Neuhaus, Michael ^{[10
]}

Franke, Jennifer ^{[11
]}

Sorici-Barb, Ioana ^{[11
]}

Noutsias, Michel ^{[12
]}

Burgdorf, Christof ^{[13
]}

Koenig, Wolfgang ^{[14
,15
]}

Kherad, Behrouz ^{[16
]}

Sarcon, Annahita ^{[17
]}

Rajan, Lawrence ^{[18
]}

Michels, Guido ^{[19
]}

Pfister, Roman ^{[19
]}

Cuneo, Alessandro ^{[20
]}

Jacobshagen, Claudius ^{[21
]}

Karakas, Mahir ^{[22
,23
]}

Pott, Alexander ^{[24
]}

Meyer, Philippe ^{[25
]}

Arroja, Jose D. ^{[25
]}

Banning, Adrian ^{[26
]}

Cuculi, Florim ^{[27
]}

Kobza, Richard ^{[27
]}

Fischer, Thomas A. ^{[28
]}

Vasankari, Tuija ^{[29
]}

Airaksinen, K. E. Juhani ^{[29
]}

Hauck, Christian ^{[30
]}

Paolini, Carla ^{[31
]}

Bilato, Claudio ^{[31
]}

Imori, Yoichi ^{[32
]}

Kato, Ken ^{[33
]}

Kobayashi, Yoshio ^{[33
]}

Opolski, Grzegorz ^{[34
]}

Budnik, Monika ^{[34
]}

Dworakowski, Rafal ^{[35
]}

MacCarthy, Philip ^{[35
]}

Kaiser, Christoph ^{[36
]}

Osswald, Stefan ^{[36
]}

Galiuto, Leonarda ^{[37
]}

Dichtl, Wolfgang ^{[38
]}

Chan, Christina ^{[39
]}

Bridgman, Paul ^{[39
]}

机构：

[1] Hannover Med Sch, Dept Cardiol & Angiol, Hannover, Germany

[2] Univ Hosp Zurich, Univ Heart Ctr, Dept Cardiol, Raemistr 100, CH-100 Zurich, Switzerland

[3] Med Univ Gdansk, Dept Cardiol 1, Gdansk, Poland

[4] Univ Bremen, FB Math & Comp Sci, Bremen, Germany

[5] IRCCS, Ctr Cardiol Monzino, Milan, Italy

[6] Univ Med Ctr Mainz, Ctr Cardiol, Cardiol 1, Mainz, Germany

[7] Univ Hosp San Giovanni Dio & Ruggi dAragona, Heart Dept, Salerno, Italy

[8] Antonio Cardarelli Hosp, Div Cardiol, Naples, Italy

[9] Univ Turin, Dept Med Sci, Div Cardiol, AOU Citt Salute & Sci, Turin, Italy

[10] Kantonsspital Frauenfeld, Dept Cardiol, Frauenfeld, Switzerland

[11] Heidelberg Univ Hosp, Dept Cardiol, Heidelberg, Germany

[12] Martin Luther Univ Halle Wittenberg, Univ Hosp Halle, Midgerman Heart Ctr, Dept Internal Med 3, Halle, Saale, Germany

[13] Heart & Vasc Ctr Bad Bevensen, Bad Bevensen, Germany

[14] Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany

[15] DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany

[16] Charite, Dept Cardiol, Campus Rudolf Virchow, Berlin, Germany

[17] Univ Calif San Francisco, Dept Med, Sect Cardiac Electrophysiol, San Francisco, CA 94143 USA

[18] TJ Hlth Partners Heart & Vasc, Glasgow, KY USA

[19] Univ Cologne, Dept Internal Med 3, Heart Ctr, Cologne, Germany

[20] Krankenhaus Maria Hilf Med Klin, Stadtlohn, Germany

[21] Georg August Univ Goettingen, Clin Cardiol & Pneumol, Gottingen, Germany

[22] Univ Heart Ctr Hamburg, Dept Gen & Intervent Cardiol, Hamburg, Germany

[23] DZHK German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Luebeck, Hamburg, Germany

[24] Univ Ulm, Med Ctr, Dept Internal Med Cardiol 2, Ulm, Germany

[25] Hop Univ Geneve, Serv Cardiol, Geneva, Switzerland

[26] Oxford Univ Hosp, John Radcliffe Hosp, Dept Cardiol, Oxford, England

[27] Kantonsspital Lucerne, Dept Cardiol, Luzern, Switzerland

[28] Kantonsspital Winterthur, Dept Cardiol, Winterthur, Switzerland

[29] Turku Univ Hosp, Heart Ctr, Turku, Finland

[30] Univ Klinikum Regensburg, Klin & Poliklin Innere Med 2, Regensburg, Germany

[31] Local Hlth Unit 8, Cardiol Unit, Vicenza, Italy

[32] Nippon Med Sch, Dept Cardiovasc Med, Tokyo, Japan

[33] Chiba Univ, Dept Cardiovasc Med, Grad Sch Med, Chiba, Japan

[34] Med Univ Warsaw, Dept Cardiol, Warsaw, Poland

[35] Kings Coll Hosp London, Dept Cardiol, London, England

[36] Univ Hosp Basel, Dept Cardiol, Basel, Switzerland

[37] Univ Cattolica Sacro Cuore, Fdn Policlin Univ Gemelli, IRCCS, Rome, Italy

[38] Med Univ Innsbruck, Univ Hosp Internal Med Cardiol & Angiol 3, Innsbruck, Austria

[39] Christchurch Hosp, Dept Cardiol, Christchurch, New Zealand

[40] Univ Med Greifswald, Dept Cardiol & Internal Med B, Greifswald, Germany

[41] DZHK German Ctr Cardiovasc Res, Partner Site Greifswald, Greifswald, Germany

[42] Univ Hosp Rangueil, Dept Cardiol & Cardiac Imaging Ctr, Toulouse, France

[43] Heidelberg Univ, Univ Med Ctr Mannheim UMM, Fac Med, Dept Med 1, Mannheim, Germany

[44] DZHK German Ctr Cardiovasc Res, Partner Site Heidelberg Mannheim, Mannheim, Germany

[45] Moscow City Hosp 1, Intens Coronary Care Unit, Moscow, Russia

[46] Univ Adelaide, Queen Elizabeth Hosp, Basil Hetzel Inst, Dept Cardiol, Adelaide, SA, Australia

[47] Charles Univ Prague, Univ Hosp Kralovske Vinohrady, Fac Med 3, Cardioctr, Prague, Czech Republic

[48] Univ Florida, Coll Med, Dept Med, Div Cardiovasc Med, Gainesville, FL USA

[49] Univ Hosp Olomouc, Dept Internal Med & Cardiol, Olomouc, Czech Republic

[50] Univ Klinikum Saarlandes, Klin Innere Med 3, Homburg, Germany

来源：

EUROPEAN HEART JOURNAL | 2020年 / 41卷 / 34期

关键词：

Takotsubo syndrome; Myocardial infarction; Acute coronary syndrome; Coronary artery disease; Cardiac catheterization; Outcome; ACUTE MYOCARDIAL-INFARCTION; SYNDROME TAKO-TSUBO; ST-SEGMENT ELEVATION; CARDIOMYOPATHY; PREVALENCE; TRIGGER; SCORE; 1ST;

D O I：

10.1093/eurheartj/ehaa210

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Takotsubo syndrome (US) is an acute heart failure syndrome, which shares many features with acute coronary syndrome (ACS). Although TTS was initially described with angiographically normal coronary arteries, smaller studies recently indicated a potential coexistence of coronary artery disease (CAD) in US patients. This study aimed to determine the coexistence, features, and prognostic role of CAD in a large cohort of patients with US. Methods and results Coronary anatomy and CAD were studied in patients diagnosed with US. Inclusion criteria were compliance with the International Takotsubo Diagnostic Criteria for TTS, and availability of original coronary angiographies with ventriculography performed during the acute phase. Exclusion criteria were missing views, poor quality of angiography loops, and angiography without ventriculography. A total of 1016 US patients were studied. Of those, 23.0% had obstructive CAD, 41.2% had non -obstructive CAD, and 35.7% had angiographically normal coronary arteries. A total of 47 patients (4.6%) underwent percutaneous coronary intervention, and 3 patients had acute and 8 had chronic coronary artery occlusion concomitant with US, respectively. The presence of CAD was associated with increased incidence of shock, ventilation, and death from any cause. After adjusting for confounders, the presence of obstructive CAD was associated with mortality at 30 days. Takotsubo syndrome patients with obstructive CAD were at comparable risk for shock and death and nearly at twice the risk for ventilation compared to an age- and sex-matched ACS cohort. Conclusions Coronary artery disease frequently coexists in US patients, presents with the whole spectrum of coronary pathology including acute coronary occlusion, and is associated with adverse outcome.

引用

页码：3255 / +

页数：14

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