Prevalence and prognostic impact of diabetes in takotsubo syndrome

• Verfasst von: Stiermaier, Thomas [VerfasserIn]
• Verfasst von: Santoro, Francesco [VerfasserIn]
• Verfasst von: El-Battrawy, Ibrahim [VerfasserIn]
• Verfasst von: Möller, Christian [VerfasserIn]
• Verfasst von: Graf, Tobias [VerfasserIn]
• Verfasst von: Novo, Giuseppina [VerfasserIn]
• Verfasst von: Santangelo, Andrea [VerfasserIn]
• Verfasst von: Mariano, Enrica [VerfasserIn]
• Verfasst von: Romeo, Francesco [VerfasserIn]
• Verfasst von: Caldarola, Pasquale [VerfasserIn]
• Verfasst von: Fanelli, Mario [VerfasserIn]
• Verfasst von: Thiele, Holger [VerfasserIn]
• Verfasst von: Brunetti, Natale Daniele [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Eitel, Ingo [VerfasserIn]
• Titel: Prevalence and prognostic impact of diabetes in takotsubo syndrome
• Titelzusatz: insights from the international, multicenter GEIST registry
• Verf.angabe: Thomas Stiermaier, Francesco Santoro, Ibrahim El-Battrawy, Christian Möller, Tobias Graf, Giuseppina Novo, Andrea Santangelo, Enrica Mariano, Francesco Romeo, Pasquale Caldarola, Mario Fanelli, Holger Thiele, Natale Daniele Brunetti, Ibrahim Akin and Ingo Eitel
• Jahr: 2018
• Umfang: 5 S.
• Fussnoten: Gesehen am 21.04.2020
• Titel Quelle: Enthalten in: Diabetes care
• Ort Quelle: Alexandria, Va. : Assoc., 1978
• Jahr Quelle: 2018
• Band/Heft Quelle: 41(2018), 5, Seite 1084-1088
• ISSN Quelle: 1935-5548
• DOI: doi:10.2337/dc17-2609
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aged
• Sach-SW: Diabetes Mellitus
• Sach-SW: Diabetic Cardiomyopathies
• Sach-SW: Female
• Sach-SW: Germany
• Sach-SW: Humans
• Sach-SW: Italy
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Prevalence
• Sach-SW: Prognosis
• Sach-SW: Registries
• Sach-SW: Risk Factors
• Sach-SW: Takotsubo Cardiomyopathy
• K10plus-PPN: 1695253884

Abstract

OBJECTIVE: In view of low prevalence rates, diabetes is discussed as a protective factor for the occurrence of Takotsubo syndrome (TTS). Furthermore, it was associated with improved outcome in a small single-center analysis. Therefore, this study assessed the prevalence and prognostic relevance of concomitant diabetes in TTS. - RESEARCH DESIGN AND METHODS: A total of 826 patients with TTS were enrolled in an international, multicenter, registry-based study (eight centers in Italy and Germany). All-cause mortality was compared between patients with diabetes and patients without diabetes, and the independent predictive value of diabetes was evaluated in multivariate regression analysis. - RESULTS: The prevalence of diabetes was 21.1% (n = 174). TTS patients with diabetes were older (P < 0.001), were more frequently male (P = 0.003), had a higher prevalence of hypertension (P < 0.001), physical triggers (P = 0.041), and typical apical ballooning (P = 0.010), had a lower left ventricular ejection fraction (P = 0.008), had a higher rate of pulmonary edema (P = 0.032), and had a longer hospital stay (P = 0.009). However, 28-day all-cause mortality did not differ between patients with diabetes and patients without diabetes (6.4% vs. 5.7%; hazard ratio [HR] 1.11 [95% CI 0.55-2.25]; P = 0.772). Longer-term follow-up after a median of 2.5 years revealed a significantly higher mortality among TTS patients with diabetes (31.4% vs. 16.5%; P < 0.001), and multivariate regression analysis identified diabetes as an independent predictor of adverse outcome (HR 1.66 [95% CI 1.16-2.39]; P = 0.006). - CONCLUSIONS: Diabetes is not uncommon in patients with TTS, is associated with increased longer-term mortality rates, and is an independent predictor of adverse outcome irrespective of additional risk factors.