Differences Between Takotsubo and the Working Diagnosis of Myocardial Infarction With Nonobstructive Coronary Arteries
Copyright © 2022 Lopez-Pais, Izquierdo Coronel, Raposeiras-Roubín, Álvarez Rodriguez, Vedia, Almendro-Delia, Sionis, Martin-Garcia, Uribarri, Blanco, Martín de Miguel, Abu-Assi, Galán Gil, Sestayo Fernández, Espinosa Pascual, Agra-Bermejo, López Otero, García Acuña, Alonso Martín, Gonzalez-Juanatey, Perez de Juan Romero and Núñez-Gil..
Aim: Whether Takotsubo syndrome (TTS) should be classified within myocardial infarction with non-obstructive coronary arteries (MINOCAs) is still controversial. The aim of this work was to evaluate the main differences between TTS and non-TTS MINOCAs.
Methods and Results: A cohort study based on two prospective registries: TTS from the RETAKO registry (N:1,015) and patients with non-TTS MINOCAs from contemporary records of acute myocardial infarction from five 5 national centers (N:1,080). Definitions and management recommended by the ESC were used. Survival analysis was based on the Cox regression analysis; propensity score matching (PS) was created to adjust prognostic variables. Takotsubo syndrome were more often women (85.9 vs. 51.9%; p < 0.001) and older (69.4 ± 12.5 vs. 64.5 ± 14.1 years; p < 0.001). Atrial fibrillation (AF) was more frequent in non-TTS MINOCAs (10.4 vs. 14.4%; p = 0.007). Psychiatric disorders were more prevalent in TTS (15.5 vs. 10.2%, p < 0.001). In-hospital mortality and complications were higher in TTS: 3.4 vs. 1.8%, (p = 0.015), and 25.8 vs. 11.5%, (p < 0.001). Global mortality before PS matching was 16.1% in non-TTS MINOCAs and 8.1% in TTS. Median follow-up was 32.4 months; after PS matching, TTS had fewer major adverse cardiovascular events (MACEs): hazard ratio (HR) 0.59; 95% CI 0.42-0.83. There were no differences in global mortality (HR 0.87; CI: 0.64-1.19), but TTS had lower cardiovascular mortality (HR 0.58; CI: 0.35-0.98).
Conclusion: Compared to the rest of MINOCAs, TTS presents a different patient profile and a more aggressive acute phase. However, its long-term cardiovascular prognosis is better. These results support that TTS should be considered a separate entity with unique characteristics and prognosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Frontiers in cardiovascular medicine - 9(2022) vom: 23., Seite 742010 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lopez-Pais, Javier [VerfasserIn] |
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| Links: |
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| Themen: |
Definition |
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| Anmerkungen: |
Date Revised 03.11.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fcvm.2022.742010 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338900357 |
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| 100 | 1 | |a Lopez-Pais, Javier |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Differences Between Takotsubo and the Working Diagnosis of Myocardial Infarction With Nonobstructive Coronary Arteries |
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| 500 | |a Date Revised 03.11.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Lopez-Pais, Izquierdo Coronel, Raposeiras-Roubín, Álvarez Rodriguez, Vedia, Almendro-Delia, Sionis, Martin-Garcia, Uribarri, Blanco, Martín de Miguel, Abu-Assi, Galán Gil, Sestayo Fernández, Espinosa Pascual, Agra-Bermejo, López Otero, García Acuña, Alonso Martín, Gonzalez-Juanatey, Perez de Juan Romero and Núñez-Gil. | ||
| 520 | |a Aim: Whether Takotsubo syndrome (TTS) should be classified within myocardial infarction with non-obstructive coronary arteries (MINOCAs) is still controversial. The aim of this work was to evaluate the main differences between TTS and non-TTS MINOCAs | ||
| 520 | |a Methods and Results: A cohort study based on two prospective registries: TTS from the RETAKO registry (N:1,015) and patients with non-TTS MINOCAs from contemporary records of acute myocardial infarction from five 5 national centers (N:1,080). Definitions and management recommended by the ESC were used. Survival analysis was based on the Cox regression analysis; propensity score matching (PS) was created to adjust prognostic variables. Takotsubo syndrome were more often women (85.9 vs. 51.9%; p < 0.001) and older (69.4 ± 12.5 vs. 64.5 ± 14.1 years; p < 0.001). Atrial fibrillation (AF) was more frequent in non-TTS MINOCAs (10.4 vs. 14.4%; p = 0.007). Psychiatric disorders were more prevalent in TTS (15.5 vs. 10.2%, p < 0.001). In-hospital mortality and complications were higher in TTS: 3.4 vs. 1.8%, (p = 0.015), and 25.8 vs. 11.5%, (p < 0.001). Global mortality before PS matching was 16.1% in non-TTS MINOCAs and 8.1% in TTS. Median follow-up was 32.4 months; after PS matching, TTS had fewer major adverse cardiovascular events (MACEs): hazard ratio (HR) 0.59; 95% CI 0.42-0.83. There were no differences in global mortality (HR 0.87; CI: 0.64-1.19), but TTS had lower cardiovascular mortality (HR 0.58; CI: 0.35-0.98) | ||
| 520 | |a Conclusion: Compared to the rest of MINOCAs, TTS presents a different patient profile and a more aggressive acute phase. However, its long-term cardiovascular prognosis is better. These results support that TTS should be considered a separate entity with unique characteristics and prognosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a MINOCA | |
| 650 | 4 | |a Takotsubo | |
| 650 | 4 | |a definition | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a working diagnosis | |
| 700 | 1 | |a Izquierdo Coronel, Bárbara |e verfasserin |4 aut | |
| 700 | 1 | |a Raposeiras-Roubín, Sergio |e verfasserin |4 aut | |
| 700 | 1 | |a Álvarez Rodriguez, Leyre |e verfasserin |4 aut | |
| 700 | 1 | |a Vedia, Oscar |e verfasserin |4 aut | |
| 700 | 1 | |a Almendro-Delia, Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Sionis, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Martin-Garcia, Agustin C |e verfasserin |4 aut | |
| 700 | 1 | |a Uribarri, Aitor |e verfasserin |4 aut | |
| 700 | 1 | |a Blanco, Emilia |e verfasserin |4 aut | |
| 700 | 1 | |a Martín de Miguel, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Abu-Assi, Emad |e verfasserin |4 aut | |
| 700 | 1 | |a Galán Gil, David |e verfasserin |4 aut | |
| 700 | 1 | |a Sestayo Fernández, Manuela |e verfasserin |4 aut | |
| 700 | 1 | |a Espinosa Pascual, Maria Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a Agra-Bermejo, Rosa María |e verfasserin |4 aut | |
| 700 | 1 | |a López Otero, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a García Acuña, Jose María |e verfasserin |4 aut | |
| 700 | 1 | |a Alonso Martín, Joaquín Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-Juanatey, Jose Ramón |e verfasserin |4 aut | |
| 700 | 1 | |a Perez de Juan Romero, Miguel Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Núñez-Gil, Iván J |e verfasserin |4 aut | |
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