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Neth Heart J. 2016 Sep;24(9):520-9. doi: 10.1007/s12471-016-0859-x.

Diagnosis of takotsubo cardiomyopathy is increasing over time in patients presenting as ST-elevation myocardial infarction.

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

A M Otten, J P Ottervanger, T Symersky, H Suryapranata, M J de Boer, A H E M Maas

Affiliations

  1. Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands. [email protected].
  2. Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
  3. Department of Cardiology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.

PMID: 27412161 PMCID: PMC5005191 DOI: 10.1007/s12471-016-0859-x

Abstract

BACKGROUND: Takotsubo cardiomyopathy often presents with the clinical signs of ST-elevation myocardial infarction (STEMI). The increase in scientific publications addressing this relatively rare condition may result in higher awareness and diagnosis of takotsubo cardiomyopathy.

AIM: To assess the observed prevalence per year of takotsubo cardiomyopathy in a large registry of patients with STEMI, during a 12-year inclusion period.

METHOD: All patients presenting with STEMI at a large regional cardiology clinic were entered into a database (n = 8,413, mean age 63 ± 13 years). Takotsubo cardiomyopathy was diagnosed in 42 patients (0.5 %). Years of evaluation were defined as 'early years' (January 2002 to December 2007; n = 4350) and 'later years' (January 2008 to December 2013). Multivariable analyses were performed to adjust for differences in demographical and clinical variables.

RESULTS: In later years, the age of STEMI patients was slightly higher (64 ± 13 vs. 63 ± 13 years, p < 0.001), with more patients with clinical symptoms of shock (10 vs. 7 %, p < 0.001) or a history of percutaneous coronary intervention or hypertension (10 vs. 8 %, p = 0.001 and 37 vs. 34 %, p < 0.001). Smoking and a positive family history were less often observed during later years (39 vs. 46 %, p < 0.001 and 37 vs. 42 % p < 0.001). Patients with takotsubo cardiomyopathy were more often female (81 vs. 27 %, p = 0.001). Takotsubo cardiomyopathy was more often diagnosed in the later period (0.7 vs. 0.3 %, OR 2.4, 95 % CI 1.2-4.6, p = 0.009). The higher prevalence of takotsubo cardiomyopathy in recent years remained significant after adjustment for differences in patient characteristics (OR 2.1, 95 % CI 1.1-4.3).

CONCLUSION: Takotsubo cardiomyopathy is currently more often diagnosed in patients with STEMI compared with in earlier years. This is probably due to the increased scientific and clinical awareness among doctors, but the prevalence is still low.

Keywords: Gender; STEMI; Takotsubo cardiomyopathy

Conflict of interest statement

Conflict of interestA.M. Otten, J.P. Ottervanger, T. Symersky, H. Suryapranata, M.J. de Boer and A.H.E.M. Maas state that there are no conflicts of interest.

References

  1. Eur Heart J Acute Cardiovasc Care. 2013 Jun;2(2):137-46 - PubMed
  2. Jpn Circ J. 2000 Feb;64(2):156-9 - PubMed
  3. Neurocrit Care. 2006;5(3):243-9 - PubMed
  4. Am Heart J. 2008 Dec;156(6):1026-34 - PubMed
  5. Am J Hematol. 2004 Jan;75(1):40-7 - PubMed
  6. Circulation. 2006 Dec 19;114(25):2806-14 - PubMed
  7. Eur Heart J. 2012 Jul;33(14):1787-847 - PubMed
  8. J Cardiol. 1991;21(2):203-14 - PubMed
  9. Eur Heart J. 2012 Oct;33(20):2569-619 - PubMed
  10. Ann Intern Med. 2004 Dec 7;141(11):858-65 - PubMed
  11. Eur Heart J Acute Cardiovasc Care. 2016 Dec;5(8):501-504 - PubMed
  12. Heart. 2003 Sep;89(9):1027-31 - PubMed
  13. Am Heart J. 2012 Jul;164(1):66-71.e1 - PubMed
  14. N Engl J Med. 2015 Sep 3;373(10 ):929-38 - PubMed
  15. J Am Heart Assoc. 2012 Aug;1(4):e001206 - PubMed
  16. Neth Heart J. 2014 Oct;22(10):456-9 - PubMed
  17. Cardiology. 2015 Jul 7;132(2):131-136 - PubMed
  18. Circ J. 2007 Jun;71(6):990-2 - PubMed
  19. Neth Heart J. 2014 May;22(5):246-8 - PubMed
  20. Heart. 2014 Nov;100(22):1804-12 - PubMed
  21. Am J Cardiol. 2015 Jun 1;115(11):1615-8 - PubMed
  22. Int J Cardiol. 2013 Oct 3;168(3):2791-5 - PubMed
  23. Am Heart J. 2014 Apr;167(4):480-488.e1 - PubMed
  24. J Cardiovasc Med (Hagerstown). 2013 Aug;14(8):576-81 - PubMed
  25. Arch Med Sci. 2010 Dec;6(6):971-5 - PubMed
  26. J Am Coll Cardiol. 2001 Jul;38(1):11-8 - PubMed
  27. Int J Cardiol. 2015 Mar 1;182:297-303 - PubMed
  28. J Cardiol. 2002 Jun;39(6):305-12 - PubMed
  29. Eur Heart J. 2006 Jul;27(13):1523-9 - PubMed
  30. ScientificWorldJournal. 2012;2012:184075 - PubMed
  31. JAMA. 2012 Sep 12;308(10):998-1006 - PubMed
  32. Mayo Clin Proc. 2011 Feb;86(2):168 - PubMed
  33. Rev Esp Cardiol (Engl Ed). 2015 Jun;68(6):505-12 - PubMed
  34. Angiology. 2010 Feb;61(2):166-73 - PubMed

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