Comorbidities Frequency in Takotsubo Syndrome: An International Collaborative Systematic Review Including 1109 Patients - 21/05/15

Doi : 10.1016/j.amjmed.2015.01.016

Francesco Pelliccia, MD ^a,^⁎ , Guido Parodi, MD ^b, Cesare Greco, MD ^a, David Antoniucci, MD ^b, Roman Brenner, MD ^c, Eduardo Bossone, MD ^d, Luca Cacciotti, MD ^e, Alessandro Capucci, MD ^f, Rodolfo Citro, MD ^d, Clément Delmas, MD ^g, Federico Guerra, MD ^f, Costin N. Ionescu, MD ^h, Olivier Lairez, MD ^g, Maiteder Larrauri-Reyes, MD ⁱ, Pil Hyung Lee, MD ^j, Nicolas Mansencal, MD ^k, Giuseppe Marazzi, MD ^l, Christos G. Mihos, MD ⁱ, Olivier Morel, MD ^m, Holger M. Nef, MD ⁿ, Ivan J. Nunez Gil, MD ^o, Ilaria Passaseo, MD ^e, Andres M. Pineda, MD ⁱ, Giuseppe Rosano, MD ^l,^p, Orlando Santana, MD ⁱ, Franziska Schneck, MD ⁿ, Bong Gun Song, MD ^q, Jae-Kwan Song, MD ^j, Andrew W. Teh, MD ^r,^s, Patompong Ungprasert, MD ^t, Alberto Valbusa, MD ^u, Andreas Wahl, MD ^v, Tetsuro Yoshida, MD ^w, Carlo Gaudio, MD ^a, Juan Carlos Kaski, MD ^p
^a Department of Cardiovascular Sciences, Sapienza University, Rome, Italy
^b Department of Heart and Vessels, Careggi Hospital, Florence, Italy
^c Department of Cardiology, Kantonsspital, CH-St.Gallen, Switzerland
^d Department of Cardiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
^e Cardiology Unit, Ospedale Vannini, Rome, Italy
^f Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Ancona, Italy
^g Department of Cardiology, Rangueil University Hospital, Toulouse, France
^h Cardiovascular Section, Yale University, New Haven, Conn
ⁱ Cardiology Department, Mount Sinai Medical Center, Miami Beach, Fla
^j Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Seoul, South Korea
^k Hôpital Ambroise Paré, Service de Cardiologie, Centre de Référence des Maladies Cardiaques Héréditaires, Université de Versailles Saint-Quentin, Boulogne, France
^l L'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana, Rome, Italy
^m Pôle d'activité medico-chirurgicale Cardiovasculaire, Strasbourg, France
ⁿ Department of Cardiology and Angiology, University of Giessen, Giessen, Germany
^o Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
^p Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, United Kingdom
^q Cardiac and Vascular Center, Konkuk University Hospital, Seoul, South Korea
^r Cardiology Department, Eastern Health Clinical School, Monash University, Victoria, Australia
^s Department of Cardiology, Austin Hospital, Victoria, Australia
^t Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
^u IRCCS Azienza Ospedaliera, Universitaria San Martino-IST, Genova, Italy
^v Cardiology, University Hospital, Bern, Switzerland
^w Department of Cardiovascular of Medicine, Onga Nakama Medical Association, Onga Hospital, Onga, Japan

^∗Requests for reprints should be addressed to Francesco Pelliccia, MD, PhD, Sapienza University, Department of Cardiovascular Sciences, Via Tommaso Inghirami 85, 00179 Rome, Italy.

Abstract

Background

To identify predisposing factors that can result in the onset of takotsubo syndrome, we performed an international, collaborative systematic review focusing on clinical characteristics and comorbidities of patients with takotsubo syndrome.

Methods

We searched and reviewed cited references up to August 2013 to identify relevant studies. Corresponding authors of selected studies were contacted and asked to provide additional quantitative details. Data from each study were extracted by 2 independent reviewers. The cumulative prevalence of presenting features and comorbidities was assessed. Nineteen studies whose authors sent the requested information were included in the systematic review, with a total of 1109 patients (951 women; mean age, 59-76 years). Evaluation of risk factors showed that obesity was present in 17% of patients (range, 2%-48%), hypertension in 54% (range, 27%-83%), dyslipidemia in 32% (range, 7%-59%), diabetes in 17% (range, 4%-34%), and smoking in 22% (range, 6%-49%). Emotional stressors preceded takotsubo syndrome in 39% of patients and physical stressors in 35%. The most common comorbidities were psychological disorders (24%; range, 0-49%), pulmonary diseases (15%; range, 0-22%), and malignancies (10%; range, 4%-29%). Other common associated disorders were neurologic diseases (7%; range, 0-22%), chronic kidney disease (7%; range, 2%-27%), and thyroid diseases (6%; range, 0-37%).

Conclusions

Patients with takotsubo syndrome have a relevant prevalence of cardiovascular risk factors and associated comorbidities. Such of associations needs to be evaluated in further studies.

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Keywords : Acute left ventricular dysfunction, Apical ballooning syndrome, Cardiomyopathy, Takotsubo cardiomyopathy, Takotsubo syndrome

Plan

Clinical Characteristics and Presenting Features

Comorbidities, the “Extracardiac” Predisposing Factors

Study Limitations

Conclusions

	Funding: None.
	Conflict of Interest: None.
	Authorship: All authors had access to the data and played a role in writing the manuscript.

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Vol 128 - N° 6

P. 654.e11-654.e19 - juin 2015 Retour au numéro

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Comorbidities Frequency in Takotsubo Syndrome: An International Collaborative Systematic Review Including 1109 Patients - 21/05/15

Abstract

Background

Methods

Conclusions

Plan

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