Coincidental coronary artery disease impairs outcome in patients with takotsubo cardiomyopathy

• Verfasst von: Bill, Verena [VerfasserIn]
• Verfasst von: El-Battrawy, Ibrahim [VerfasserIn]
• Verfasst von: Schramm, Katja [VerfasserIn]
• Verfasst von: Ansari, Uzair [VerfasserIn]
• Verfasst von: Hoffmann, Ursula [VerfasserIn]
• Verfasst von: Haghi, Dariusch [VerfasserIn]
• Verfasst von: Kuschyk, Jürgen [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Coincidental coronary artery disease impairs outcome in patients with takotsubo cardiomyopathy
• Verf.angabe: V. Bill, I. El-Battrawy, K. Schramm, U. Ansari, U. Hoffmann, D. Haghi, J. Kuschyk, M. Borggrefe and I. Akin
• Jahr: 2017
• Umfang: 6 S.
• Fussnoten: Published: 14 March 2017 ; Gesehen am 9.06.2018
• Titel Quelle: Enthalten in: QJM
• Ort Quelle: Oxford : Oxford Univ. Press, 1994
• Jahr Quelle: 2017
• Band/Heft Quelle: 110(2017), 8, Seite 483-488
• ISSN Quelle: 1460-2393
• DOI: doi:10.1093/qjmed/hcx035
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1577035607

Abstract

Background and aim: Takotsubo cardiomyopathy (TC) is an important differential diagnosis of coronary artery disease (CAD), mimicking acute coronary syndrome in clinical symptoms, biomarker profiles and ST-elevation in ECG. Absence of occlusive coronary disease is an essential criterion distinguishing both diseases. The aim of the study was to explore the influence of co-existing incidental CAD on poorer clinical outcomes and all-cause mortality in TC. Design, methods and results: Our mono-centric study cohort constituted 114 consecutive patients diagnosed with TC between 2003 and 2015. The primary endpoint was the all-cause mortality. Additionally, we compared the incidence of thromboembolic events, life-threatening arrhythmias, cardiogenic shock and in-hospital death. There was no significant difference in gender distribution or mean age in both groups. Patients diagnosed with a co-existing CAD (n = 22), had a more pronounced cardiovascular risk profile. The all-cause mortality among patients with co-existing CAD after a 2-year follow-up was higher than those diagnosed with lone TC (22.7 vs. 5.4 %, P = 0.07). In a multivariate cox regression analysis CAD (HR 3.5, 95 %CI 1.0-11.6; P = 0.04), LVEF ≤ 35% (HR 3.8, 95% CI 0.0-0.6, P = 0.01) and cardiogenic shock (HR 3.8, 95% CI 1.2-11.3; P = 0.01) were independent predictors of the primary endpoint. Conclusion: Our study reveals that co-existing CAD impairs the outcome in patients with TC. The diagnostic work-up for TC should therefore not necessarily hinge on ruling out CAD.