P817Shall takotsubo syndrome be tear apart from the working diagnosis of myocardial infarction with non-obstructive coronary arteries?
| Autor: | J F Oteo Dominguez, L Alvarez Rodriguez, J J Alonso Martin, I Nunez Gil, A Nunez Rodriguez, P Awamleh Garcia, D Galan Gil, M J Espinosa Pascual, B Izquierdo Coronel, J Lopez Pais, B Alcon Duran, J R Gonzalez Juanatey, J Gorriz Magana, C Moreno Vinues, C G Martinez Peredo |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
biology business.industry Ischemia Infarction Atrial fibrillation medicine.disease Troponin Coronary arteries medicine.anatomical_structure Internal medicine Shock (circulatory) medicine Cardiology biology.protein Myocardial infarction medicine.symptom Cardiology and Cardiovascular Medicine business Killip class |
| Zdroj: | European Heart Journal. 40 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehz747.0416 |
| Popis: | Background There is controversy to whether Takotsubo Syndrome (TTS) should be classified as a Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA). The aim of this study is to compare the clinical profile and prognosis of TTS with non-TTS MINOCA patients. Methods Analytical and observational study developed in a University Hospital, which covers 220.000 individual. We analyzed the clinical data of all consecutive MINOCA patients admitted to our center during a 3 years period (2016–2018). We used the definitions and the clinical management of 2016 ESC Working Group Position Paper on MINOCA, which considers TTS as a MINOCA. Follow up analysis included death from any cause and major adverse cardiovascular events (MACE). Survival analysis is based on Cox regression. Median follow-up was 17 months. Results Twenty-six out of 109 patients (24%) classified as MINOCA where TTS. Patients with TTS were older (72.2±11.5 vs 62.3±14.9, p TTS patients at admission referred angina as the main symptom in fewer cases (56.0 vs 78.0%, p 0.03), but they had an electrocardiogram suggesting ischemia more frequently (87.5 vs 53.7%, p The proportion of in-hospital complications (recovered cardiac arrest, shock, pulmonary edema, ictus, re-infarction) were higher in the TTS group (40.0 vs 6.1%, p During follow-up, TTS showed worse prognosis, with higher all-cause mortality: 16.0 vs 4.0%, Hazard Ratio (HR) 4.49 (Confidence Interval [CI] 1.01–20.10, p Conclusion There are differences in the clinical profile and prognosis of TTS patients compared to the rest of non-TTS MINOCA, being TTS a more aggressive entity. We think these data are in line with the recently released 4th Universal Definition of Myocardial Infarction, where TTS should be considered apart from the rest causes of “myocardial injury” or “myocardial infarction”, being an entity with its own characteristics and prognosis. |
| Databáze: | OpenAIRE |
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