Predictors of outcome in takotsubo cardiomyopathy. A multicenter study

Abstract

Introduction: Takotsubo cardiomyopathy (TC) is characterized by a transient left ventricular (LV) dysfunction in the absence of significant coronary artery disease. The predictors of prognosis of TC are not yet fully established. Objectives: To identify predictors of outcome in patients (P) diagnosed with TC. Methods: Multicenter studyinvolving 5 hospital centers that included all patients diagnosed with TC in the last 10 years. We assessed demographic data, precipitating factors and clinical presentation, trying to establish the predictors of after discharge outcomes. Results: We included 71 P diagnosed with TC. During hospitalization (6.1+4.6 days) occurred complications: heart failure (31%), cardiogenic shock (15.5%), atrial fibrillation (9.9%), complete atrioventricular block (4.2 %), acute pulmonary edema (4.2%), stroke / TIA (2.8%), LV thrombus (1.4%) and death (1.4%). Over a follow-up of 31+29 months, there were: TC recurrence (4.2%), stroke / TIA (4.2%) and death (1.4%). The following variables were identified as predictors of complications at follow-up: (i) ST segment depression on admission EKG was a predictor of TC recurrence (p=0,016); (ii) Chronic renal failure was a predictor of stroke/TIA (p=0.023) and death (p=0,027). Conclusion: TC has a low rate of complications in the follow-up. Chronic renal failure is a predictor of death and also of stroke in the follow-up. The admission EKG may have a prognostic role and ST segment depression was the only identified predictor of TC recurrence. Our results need confirmation in larger studies.