Takotsubo Syndrome, Stressful Triggers, and Risk of Recurrence

The risk of recurrence in takotsubo syndrome (TTS) appears to be low, although previous studies have shown conflicting results and factors associated with recurrences are unclear. The aim of this study is to evaluate the incidence and predictors of TTS recurrences. Adult patients included in the Spa...

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Published in:The American journal of cardiology 2023-10, Vol.205, p.58-62
Main Authors: Fernández-Cordón, Clara, Núñez-Gil, Iván Javier, Martín de Miguel, Irene, Pérez-Castellanos, Alberto, Vedia, Oscar, Almendro-Delia, Manuel, López-País, Javier, Uribarri, Aitor, Duran-Cambra, Albert, Martín-García, Agustín, Raposeiras-Roubin, Sergio, Blanco-Ponce, Emilia, Corbí-Pascual, Miguel, Guillén Marzo, Marta, Andrés, Mireia, Feltes, Gisela, Martínez-Selles, Manuel
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Language:English
Subjects:
Catecholamines
Ejection fraction
Medical records
Mortality
Pathophysiology
recurrences
Regression models
Statistical analysis
stressful triggers
takotsubo syndrome
Variables
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creator Fernández-Cordón, Clara
Núñez-Gil, Iván Javier
Martín de Miguel, Irene
Pérez-Castellanos, Alberto
Vedia, Oscar
Almendro-Delia, Manuel
López-País, Javier
Uribarri, Aitor
Duran-Cambra, Albert
Martín-García, Agustín
Raposeiras-Roubin, Sergio
Blanco-Ponce, Emilia
Corbí-Pascual, Miguel
Guillén Marzo, Marta
Andrés, Mireia
Feltes, Gisela
Martínez-Selles, Manuel
description The risk of recurrence in takotsubo syndrome (TTS) appears to be low, although previous studies have shown conflicting results and factors associated with recurrences are unclear. The aim of this study is to evaluate the incidence and predictors of TTS recurrences. Adult patients included in the Spanish Multicenter REgistry of TAKOtsubo syndrome (RETAKO) between January 2003 and September 2019 were identified. Patients were categorized based on recurrences during follow-up and a multivariate logistic regression model was used to identify factors associated with recurrences. A total of 1097 patients (mean age 71.0±11.9 years, 87% females) were included, repeated TTS events were documented in 44 patients (4.0%), including 13 patients with prior TTS and 31 patients with recurrent TTS during a median follow-up of 279 days. Two patients (0.02%) had two episodes of recurrence. Compared to patients who had no recurrence of TTS, those with recurrent TTS more frequently had no identifiable stressful trigger in the index admission (20 [64.5%] vs 352 [33.0%], p
doi_str_mv 10.1016/j.amjcard.2023.07.155
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The aim of this study is to evaluate the incidence and predictors of TTS recurrences. Adult patients included in the Spanish Multicenter REgistry of TAKOtsubo syndrome (RETAKO) between January 2003 and September 2019 were identified. Patients were categorized based on recurrences during follow-up and a multivariate logistic regression model was used to identify factors associated with recurrences. A total of 1097 patients (mean age 71.0±11.9 years, 87% females) were included, repeated TTS events were documented in 44 patients (4.0%), including 13 patients with prior TTS and 31 patients with recurrent TTS during a median follow-up of 279 days. Two patients (0.02%) had two episodes of recurrence. Compared to patients who had no recurrence of TTS, those with recurrent TTS more frequently had no identifiable stressful trigger in the index admission (20 [64.5%] vs 352 [33.0%], p &lt;0.001). Primary TTS, defined as TTS without physical trigger, was also more common in the recurrence group (93.5% vs 68.3%, p &lt;0.001). The only factor independently associated with recurrences was the absence of an identifiable trigger (odds ratio 3.7 [95% confidence interval 1.8-7.8], p=0.001). In conclusion, our data indicate that for patients presenting with TTS, the rate of early recurrent TTS is approximately 4% per year. Among TTS patients, those who have no identifiable trigger events appear to have a higher rate of recurrence. •Overall, patients who have experienced an episode of takotsubo syndrome have an approximately 4% risk of recurrence in the first year after the event.•Patients who experience takotsubo syndrome in the absence of a definable trigger event have more frequent recurrences than do those with an identifiable trigger.•Patients who experience takotsubo syndrome in the absence of a definable trigger event may be more susceptible to the disease.•A prospective randomized trial of pharmacologic prophylaxis should be considered for patients at high risk of recurrence.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2023.07.155</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>Catecholamines ; Ejection fraction ; Medical records ; Mortality ; Pathophysiology ; recurrences ; Regression models ; Statistical analysis ; stressful triggers ; takotsubo syndrome ; Variables</subject><ispartof>The American journal of cardiology, 2023-10, Vol.205, p.58-62</ispartof><rights>2023 Elsevier Inc.</rights><rights>2023. 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Primary TTS, defined as TTS without physical trigger, was also more common in the recurrence group (93.5% vs 68.3%, p &lt;0.001). The only factor independently associated with recurrences was the absence of an identifiable trigger (odds ratio 3.7 [95% confidence interval 1.8-7.8], p=0.001). In conclusion, our data indicate that for patients presenting with TTS, the rate of early recurrent TTS is approximately 4% per year. 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The aim of this study is to evaluate the incidence and predictors of TTS recurrences. Adult patients included in the Spanish Multicenter REgistry of TAKOtsubo syndrome (RETAKO) between January 2003 and September 2019 were identified. Patients were categorized based on recurrences during follow-up and a multivariate logistic regression model was used to identify factors associated with recurrences. A total of 1097 patients (mean age 71.0±11.9 years, 87% females) were included, repeated TTS events were documented in 44 patients (4.0%), including 13 patients with prior TTS and 31 patients with recurrent TTS during a median follow-up of 279 days. Two patients (0.02%) had two episodes of recurrence. Compared to patients who had no recurrence of TTS, those with recurrent TTS more frequently had no identifiable stressful trigger in the index admission (20 [64.5%] vs 352 [33.0%], p &lt;0.001). Primary TTS, defined as TTS without physical trigger, was also more common in the recurrence group (93.5% vs 68.3%, p &lt;0.001). The only factor independently associated with recurrences was the absence of an identifiable trigger (odds ratio 3.7 [95% confidence interval 1.8-7.8], p=0.001). In conclusion, our data indicate that for patients presenting with TTS, the rate of early recurrent TTS is approximately 4% per year. 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subjects Catecholamines
Ejection fraction
Medical records
Mortality
Pathophysiology
recurrences
Regression models
Statistical analysis
stressful triggers
takotsubo syndrome
Variables
title Takotsubo Syndrome, Stressful Triggers, and Risk of Recurrence
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