Citations 2
Cardiac troponin elevation and mortality in takotsubo syndrome: New insights from the international takotsubo registry
Stähli, Barbara E. , Schindler, Matthias , Schweiger, Victor , Cammann, Victoria L. , Szawan, Konrad A. , Niederseer, David , Würdinger, Michael , Schönberger, Alexander, Schönberger, Maximilian, Koleva, Iva, Mercier, Julien C., Petkova, Vanya, Mayer, Silvia, Gili, Sebastiano , Franke, Jennifer , Meder, Benjamin , Jaguszewski, Miłosz, Knorr, Maike, Jansen, Thomas , Lewinski, Dirk von , Burgdorf, Christof , Kherad, Behrouz , Tschöpe, Carsten , Sarcon, Annahita, Shinbane, Jerold S., Rajan, Lawrence, Michels, Guido, Pfister, Roman , Jacobshagen, Claudius, Karakas, Mahir , Pott, Alexander , Meyer, Philippe , Roffi, Marco , Wolfrum, Mathias , Fischer, Thomas, Vasankari, Tuija , Dworakowski, Rafał , MacCarthy, Philip , Osswald, Stefan , Galiuto, Leonarda , Chan, Christina , Bridgman, Paul , Beug, Daniel , Gilyarova, Ekaterina, Gilyarov, Mikhail , Akın, İbrahim , Poledníková, Karolína, Massoomi, Michael , Carrilho‐Ferreira, Pedro , Hauck, Christian , Paolini, Carla , Bilato, Claudio , Kobayashi, Yoshio , Ishibashi, Iwao, Himi, Toshiharu, Din, Jehangir , Rihal, Charanjit S. , Liu, Kan , Jörg, Lucas, Rickli, Hans , Böhm, M., Pinto, Fausto J. , Widimský, Petr , Felix, Stephan B. , Rottbauer, Wolfgang , Budnik, Monika , Opolski, Grzegorz , Thiele, Holger, Kong, William, Dalakoti, Mayank , Imori, Yoichi , Liberale, Luca , Münzel, Thomas , Bax, J. J., Ghadri, Jelena R. , Vece, Davide Di , Templin, Christian , Budnik, Monika , Roffi, Marco , Liberale, Luca , Montecucco, Fabrizio , von Lewinski, Dirk , Tschöpe, Carsten , Meyer, Philippe , Bilato, Claudio , Citro, Rodolfo , Vecchione, Carmine , Bossone, Eduardo , Neuhaus, Michael, Noutsias, Michel , D’Ascenzo, Fabrizio, Dichtl, Wolfgang , Cuneo, Alessandro , Köenig, Wolfgang , Banning, Adrian , Cuculi, Florim , Kobza, Richard , Airaksinen, Juhani , Napp, L. Christian , Kaiser, Christoph A. , Delmas, Clément , Lairez, Olivier , Shilova, Alexandra S. , El‐Battrawy, Ibrahim , Toušek, Petr , Winchester, David E. , Gałuszka, Jan , Ukena, Christian , Poglajen, Gregor , Kato, Ken , Al‐Shammari, Ali Saad , Prasad, Abhiram , Rihal, Charanjit S. , Schulze, Paul Christian , Bianco, Matteo , Pestana, Gonçalo , Nguyen, Thanh Ha Tuan , Maier, Lars S. , Braun-Dullaeus, Ruediger Christian , Hasenfuß, Gerd , Pieske, Burkert , Schunkert, Heribert , Thiele, Holger , Bauersachs, Johann , Horowitz, John D. , Mario, Carlo Di , Crea, Filippo , Luescher, T F , Ruschitzka, Frank T.
European Journal of Clinical Investigation | October 14, 2024 | Volume: 54 | Issue: 12 | Pages: No page available
AbstractBackgroundThe clinical relevance of cardiac troponin (cTn) elevation in takotsubo syndrome (TTS) remains uncertain. The present study sought to investigate the role of cardiac troponin (cTn) elevations in mortality prediction of patients with Takotsubo syndrome (TTS).MethodsPatients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to February 2020 with available data on peak cTn levels were included in the analysis. Peak cTn levels during the index hospitalization were used to define clinically relevant myocardial injury. The threshold at which clinically relevant myocardial injury drives mortality at 1 year was identified using restricted cubic spline analysis.ResultsOut of 2′938 patients, 222 (7.6%) patients died during 1‐year follow‐up. A more than 28.8‐fold increase of cTn above the upper reference limit was identified as threshold for clinically relevant myocardial injury. The presence of clinically relevant myocardial injury was significantly associated with an increased risk of mortality at 5 years (adjusted HR 1.58, 95% CI 1.18–2.12, p =.002). Clinically relevant myocardial injury was related to an increased 5‐year mortality risk in patients with apical TTS (adjusted HR 1.57, 95% CI 1.21–2.03, p =.001), in presence of physical stressors (adjusted HR 1.60, 95% CI 1.22–2.11, p =.001), and in absence of emotional stressors (adjusted HR 1.49, 95% CI, 1.17–1.89, p =.001).ConclusionThis study for the first time determined a troponin threshold for the identification of TTS patients at excess risk of mortality. These findings advance risk stratification in TTS and assist in identifying patients in need for close monitoring and follow‐up.
Prognostic Impact of Acute Pulmonary Triggers in Patients with Takotsubo Syndrome: New Insights from the International Takotsubo Registry
Cammann, Victoria L. , Napp, L. Christian , Szawan, Konrad A. , Micek, Jozef, Dreiding, Sara, Levinson, Rena A. , Petkova, Vanya, Würdinger, Michael , Sumalinog, Rafael, Gili, Sebastiano , Clarenbach, Christian F. , Kohler, Malcolm , Wischnewsky, Manfred , Citro, Rodolfo , Vecchione, Carmine , Bossone, Eduardo , Franke, Jennifer , Meder, Benjamin , Knorr, Maike, Heiner, Susanne, Burgdorf, Christof , Kherad, Behrouz , Tschöpe, Carsten , Sarcon, Annahita, Shinbane, Jerold S., Rajan, Lawrence, Michels, Guido, Pfister, Roman , Cuneo, Alessandro , Jacobshagen, Claudius, Karakas, Mahir , Köenig, Wolfgang , Pott, Alexander , Meyer, Philippe , Roffi, Marco , Banning, Adrian , Wolfrum, Mathias , Cuculi, Florim , Fischer, Thomas, Vasankari, Tuija , Budnik, Monika , Dworakowski, Rafał , MacCarthy, Philip , Osswald, Stefan , Galiuto, Leonarda , Chan, Christina , Bridgman, Paul , Beug, Daniel , Gilyarova, Ekaterina, Gilyarov, Mikhail , El‐Battrawy, Ibrahim , Akın, İbrahim , Kozel, Martin , Winchester, David E. , Ukena, Christian , Carrilho‐Ferreira, Pedro , Hauck, Christian , Paolini, Carla , Bilato, Claudio , Sano, Masanori, Ishibashi, Iwao, Takahara, Masayuki, Himi, Toshiharu, Kobayashi, Yoshio , Prasad, Abhiram , Rihal, Charanjit S. , Liu, Kan , Bianco, Matteo , Jörg, Lucas, Rickli, Hans , Pestana, Gonçalo , Böhm, Michael , Maier, Lars S. , Pinto, Fausto J. , Widimský, Petr , Felix, Stephan B. , Opolski, Grzegorz , Rottbauer, Wolfgang , Pieske, Burkert , Borggrefe, Martin, Katus, Hugo A. , Münzel, Thomas , Crea, Filippo , Lüscher, Thomas F. , Ghadri, Jelena R. , Templin, Christian , Gilyarov, Mikhail , Bossone, Eduardo , Crea, Filippo , Citro, Rodolfo , El-Battrawy, Ibrahim , Prasad, Abhiram , Vecchione, Carmine , Tschöpe, Carsten , Koenig, Wolfgang , Meyer, Philippe , Banning, Adrian , Gilyarov, Mikhail , Ukena, Christian , Bilato, Claudio , Bianco, Matteo , Kato, Ken , Patrascu, Alexandru , Neuhaus, Michael, Jaguszewski, Miłosz , Noutsias, Michel , D’Ascenzo, Fabrizio , Dichtl, Wolfgang , Kobza, Richard , Airaksinen, Juhani , Kaiser, Christoph A. , Delmas, Clément , Lairez, Olivier , Shilova, Alexandra S. , Toušek, Petr , Gałuszka, Jan , Poglajen, Gregor , Rihal, Charanjit S. , Schulze, Paul Christian , Nguyen, Thanh Ha Tuan , Braun-Dullaeus, Ruediger Christian , Hasenfuß, Gerd , Schunkert, Heribert , Thiele, Hölger , Bauersachs, Johann , Horowitz, John D. , Mario, Carlo Di , Bax, Jeroen J. , Ruschitzka, Frank T.
ESC Heart Failure | March 13, 2021 | Volume: 8 | Issue: 3 | Pages: 1924-1932
Abstract Aims Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes. Methods and results Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33–3.38; P = 0.002). Conclusions The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.